0000784199-22-000124 | 10-Q | XBRL Viewer

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Document And Entity Information - shares	3 Months Ended
Document And Entity Information - shares	Mar. 31, 2022	Apr. 29, 2022
Document And Entity Information [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2022
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	1-13165
Entity Registrant Name	ARTIVION, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	59-2417093
Entity Address, Address Line One	1655 Roberts Boulevard, NW
Entity Address, City or Town	Kennesaw
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30144
City Area Code	770
Local Phone Number	419-3355
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	AORT
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		40,201,565
Document Fiscal Year Focus	2022
Entity Central Index Key	0000784199
Document Fiscal Period Focus	Q1
Amendment Flag	false

Condensed Consolidated Statements Of Operations And Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenues:
Total revenues	$ 77,213	$ 71,087
Cost of products and preservation services:
Total cost of products and preservation services	26,494	23,249
Gross margin	50,719	47,838
Operating expenses:
General, administrative, and marketing	38,955	38,638
Research and development	10,128	7,754
Total operating expenses	49,083	46,392
Operating income	1,636	1,446
Interest expense	3,948	4,040
Interest income	(16)	(24)
Other expense, net	133	1,931
Loss before income taxes	(2,429)	(4,501)
Income tax expense (benefit)	960	(1,363)
Net loss	$ (3,389)	$ (3,138)
Loss per share:
Basic	$ (0.08)	$ (0.08)
Diluted	$ (0.08)	$ (0.08)
Weighted-average common shares outstanding:
Basic	39,850	38,738
Diluted	39,850	38,738
Net loss	$ (3,389)	$ (3,138)
Other Comprehensive loss:
Foreign currency translation adjustments	(3,775)	(10,290)
Comprehensive loss	(7,164)	(13,428)
Products [Member]
Revenues:
Total revenues	57,542	53,345
Cost of products and preservation services:
Total cost of products and preservation services	17,408	14,911
Preservation Services [Member]
Revenues:
Total revenues	19,671	17,742
Cost of products and preservation services:
Total cost of products and preservation services	$ 9,086	$ 8,338

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 51,408	$ 55,010
Trade receivables, net	54,998	53,019
Other receivables	4,577	5,086
Inventories, net	76,208	76,971
Deferred preservation costs, net	43,964	42,863
Prepaid expenses and other	13,378	14,748
Total current assets	244,533	247,697
Goodwill	247,829	250,000
Acquired technology, net	162,458	166,994
Operating lease right-of-use assets, net	44,365	45,714
Property and equipment, net	37,459	37,521
Other intangibles, net	33,697	34,502
Deferred income taxes	3,489	2,357
Other assets	8,026	8,267
Total assets	781,856	793,052
Current liabilities:
Accounts payable	9,230	10,395
Accrued compensation	9,571	13,163
Accrued expenses	9,396	7,687
Taxes payable	5,575	3,634
Accrued procurement fees	2,206	3,689
Current maturities of operating leases	3,362	3,149
Current portion of long-term debt	1,622	1,630
Other liabilities	1,875	1,606
Total current liabilities	42,837	44,953
Long-term debt	307,232	307,493
Contingent consideration	47,600	49,400
Non-current maturities of operating leases	43,679	44,869
Non-current finance lease obligations	4,156	4,374
Deferred income taxes	26,373	28,799
Deferred compensation liability	5,766	5,952
Other liabilities	6,721	6,484
Total liabilities	484,364	492,324
Commitments and contingencies
Shareholders' equity:
Preferred stock
Common stock (issued shares of 41,688 in 2022 and 41,397 in 2021)	417	414
Additional paid-in capital	326,799	322,874
Retained (deficit) earnings	(1,414)	1,975
Accumulated other comprehensive loss	(13,662)	(9,887)
Treasury stock, at cost, 1,487 shares as of March 31, 2022 and December 31, 2021, respectively	(14,648)	(14,648)
Total shareholders' equity	297,492	300,728
Total liabilities and shareholders' equity	$ 781,856	$ 793,052

Condensed Consolidated Balance Sheets (Parenthetical) - shares shares in Thousands	Mar. 31, 2022	Dec. 31, 2021
Condensed Consolidated Balance Sheets [Abstract]
Common stock, shares issued	41,688	41,397
Treasury stock at cost, shares	1,487	1,487

Condensed Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Net cash flows from operating activities:
Net loss	$ (3,389)	$ (3,138)
Adjustments to reconcile net loss to net cash from operating activities:
Depreciation and amortization	5,881	6,006
Non-cash compensation	3,166	2,480
Non-cash lease expense	1,920	1,758
Write-down of inventories and deferred preservation costs	989	1,274
Change in fair value of contingent consideration	(1,800)	970
Deferred income taxes	(2,966)	(4,241)
Other	496	787
Changes in operating assets and liabilities:
Prepaid expenses and other assets	1,494	(1,291)
Inventories and deferred preservation costs	(1,359)	(5,933)
Receivables	(1,710)	(3,301)
Accounts payable, accrued expenses, and other liabilities	(3,320)	1,590
Net cash flows used in operating activities	(598)	(3,039)
Net cash flows from investing activities:
Capital expenditures	(2,239)	(1,502)
Other	(469)	692
Net cash flows used in investing activities	(2,708)	(810)
Net cash flows from financing activities:
Proceeds from exercise of stock options and issuance of common stock	2,318	861
Repayment of debt	(694)	(701)
Redemption and repurchase of stock to cover tax withholdings	(1,730)	(1,813)
Other	(129)	(442)
Net cash flows used in financing activities	(235)	(2,095)
Effect of exchange rate changes on cash and cash equivalents	(61)	1,088
Decrease in cash and cash equivalents	(3,602)	(4,856)
Cash and cash equivalents beginning of period	55,010	61,958
Cash and cash equivalents end of period	$ 51,408	$ 57,102

Condensed Consolidated Statements Of Shareholders' Equity - USD ($) shares in Thousands, $ in Thousands	Common Stock [Member]	Additional Paid-In Capital [Member] Cumulative Effect, Period of Adoption, Adjustment [Member]	Additional Paid-In Capital [Member]	Retained Earnings [Member] Cumulative Effect, Period of Adoption, Adjustment [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Loss [Member]	Treasury Stock [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]	Total
Balance at Dec. 31, 2020	$ 404	$ (16,426)	$ 316,192	$ (3,213)	$ 20,022	$ 6,743	$ (14,648)	$ (19,639)	$ 328,713
Balance, shares at Dec. 31, 2020	40,394						(1,487)
Net loss					(3,138)				(3,138)
Other comprehensive loss						(10,290)			(10,290)
Equity compensation	$ 2		2,635						2,637
Equity compensation, shares	207
Exercise of options			271						271
Exercise of options, shares	19
Employee stock purchase plan	$ 1		589						590
Employee stock purchase plan, shares	37
Redemption and repurchase of stock to cover tax withholdings	$ (1)		(1,812)						(1,813)
Redemption and repurchase of stock to cover tax withholdings, shares	(72)
Balance at Mar. 31, 2021	$ 406		301,449		13,671	(3,547)	$ (14,648)		297,331
Balance, shares at Mar. 31, 2021	40,585						(1,487)
Balance at Dec. 31, 2021	$ 414		322,874		1,975	(9,887)	$ (14,648)		300,728
Balance, shares at Dec. 31, 2021	41,397						(1,487)
Net loss					(3,389)				(3,389)
Other comprehensive loss						(3,775)			(3,775)
Equity compensation	$ 2		3,338						3,340
Equity compensation, shares	205
Exercise of options	$ 2		1,678						1,680
Exercise of options, shares	140
Employee stock purchase plan			638						638
Employee stock purchase plan, shares	37
Redemption and repurchase of stock to cover tax withholdings	$ (1)		(1,729)						(1,730)
Redemption and repurchase of stock to cover tax withholdings, shares	(91)
Balance at Mar. 31, 2022	$ 417		$ 326,799		$ (1,414)	$ (13,662)	$ (14,648)		$ 297,492
Balance, shares at Mar. 31, 2022	41,688						(1,487)

Basis Of Presentation And Summary Of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2022
Basis Of Presentation And Summary Of Significant Accounting Policies [Abstract]
Basis Of Presentation And Summary Of Significant Accounting Policies	1. Basis of Presentation and Summary of Significant Accounting Policies Overview The accompanying Condensed Consolidated Financial Statements include the accounts of Artivion, Inc. and its subsidiaries (“Artivion,” the “Company,” “we,” or “us”). All significant intercompany accounts and transactions have been eliminated in consolidation. The accompanying Condensed Consolidated Balance Sheet as of December 31, 2021 has been derived from audited financial statements. The accompanying unaudited Condensed Consolidated Financial Statements as of, and for the three months ended, March 31, 2022 and 2021 have been prepared in accordance with (i) accounting principles generally accepted in the US for interim financial information and (ii) the instructions to Form 10-Q and Rule 10-01 of Regulation S-X of the US Securities and Exchange Commission (the “SEC”). Accordingly, such statements do not include all the information and disclosures that are required by accounting principles generally accepted in the US for a complete presentation of financial statements. In the opinion of management, all adjustments (including those of a normal, recurring nature) considered necessary for a fair presentation have been included. Operating results for the three months ended March 31, 2022 are not necessarily indicative of the results that may be expected for the year ending December 31, 2022. These Condensed Consolidated Financial Statements should be read in conjunction with the Consolidated Financial Statements and Notes included in Artivion’s Annual Report on Form 10-K for the year ended December 31, 2021 filed with the SEC on February 22, 2022. Significant Accounting Policies A summary of our significant accounting policies is included in Note 1 of the “Notes to Consolidated Financial Statements” contained in our Form 10-K for the year ended December 31, 2021. Management believes that the consistent application of these policies enables us to provide users of the financial statements with useful and reliable information about our operating results and financial condition. The Condensed Consolidated Financial Statements are prepared in accordance with accounting principles generally accepted in the US, which require us to make estimates and assumptions. We did not experience any significant changes during the three months ended March 31, 2022 in any of our Significant Accounting Policies from those contained in our Form 10-K for the year ended December 31, 2021. New Accounting Standards Recently Adopted In August 2020 the Financial Accounting Standards Board (the “FASB”) issued Accounting Standard Update (“ASU”) Update No. 2020-06, Debt - Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging - Contracts in Entity’s Own Equity (Subtopic 815-40) (“ASU 2020-06”). The update simplifies the accounting for convertible instruments by eliminating two accounting models (i.e., the cash conversion model and beneficial conversion feature model) and reducing the number of embedded conversion features that could be recognized separately from the host contract. ASU 2020-06 also enhances transparency and improves disclosures for convertible instruments and earnings per share guidance. On January 1, 2021 we adopted ASU 2020-06 using the modified retrospective approach. See Note 8 for further discussion of convertible debt. Not Yet Effective In March 2020 the FASB issued ASU 2020-04, Reference Rate Reform Topic 848 (“ASC 848”). The amendments in this ASU were put forth in response to the market transition from the LIBOR and other interbank offered rates to alternative reference rates. Accounting principles generally accepted in the United States of America require entities to evaluate whether a contract modification, such as the replacement or change of a reference rate, results in the establishment of a new contract or continuation of an existing contract. ASC 848 allows an entity to elect not to apply certain modification accounting requirements to contracts affected by reference rate reform. The standard provides this temporary election through December 31, 2022 and cannot be applied to contract modifications that occur after December 31, 2022. We are in the process of evaluating the effect that the adoption of this standard will have on our financial position and results of operations. ‎

Financial Instruments

3 Months Ended

Mar. 31, 2022

Financial Instruments [Abstract]

Financial Instruments

2. Financial Instruments

The following is a summary of our financial instruments measured at fair value on a recurring basis (in thousands):



March 31, 2022	Level 1		Level 2		Level 3		Total
Cash equivalents:
Money market funds	$	10,018	$	--	$	--	$	10,018
Total assets	$	10,018	$	--	$	--	$	10,018

Long-term liabilities:
Contingent consideration		--		--		(47,600)		(47,600)
Total liabilities	$	--	$	--	$	(47,600)	$	(47,600)


December 31, 2021	Level 1		Level 2		Level 3		Total
Cash equivalents:
Money market funds	$	10,015	$	--	$	--	$	10,015
Total assets	$	10,015	$	--	$	--	$	10,015

Long-term liabilities:
Contingent consideration		--		--		(49,400)		(49,400)
Total liabilities	$	--	$	--	$	(49,400)	$	(49,400)

We used prices quoted from our investment advisors to determine the Level 1 valuation of our investments in money market funds.

On September 2, 2020 we entered into a Securities Purchase Agreement to acquire 100% of the outstanding equity interests of Ascyrus Medical LLC (“Ascyrus”). Ascyrus developed the AMDS, the world’s first aortic arch remodeling device for use in the treatment of acute Type A aortic dissections. As part of the acquisition, we may be required to pay additional consideration in cash and equity up to $120.0 million to the former shareholders of Ascyrus upon the achievement of certain milestones and the sales-based additional earnout.

The contingent consideration represents the estimated fair value of future potential payments. The fair value of the contingent consideration liability was estimated by discounting to present value the contingent payments expected to be made based on a probability-weighted scenario approach. We applied a discount rate based on our unsecured credit spread and the term commensurate risk-free rate to the additional consideration to be paid, and then applied a risk-based estimate of the probability of achieving each scenario to calculate the fair value of the contingent consideration. This fair value measurement was based on unobservable inputs, including management estimates and assumptions about the future achievement of milestones and future estimate of revenues, and is, therefore, classified as Level 3 within the fair value hierarchy. We used a discount rate of approximately 10% and estimated future achievement of milestone dates between 2025 and 2026 to calculate the fair value of contingent consideration as of March 31, 2022. We will remeasure this liability at each reporting date and will record changes in the fair value of the contingent consideration in General, administrative, and marketing expenses on the Condensed Consolidated Statements of Operations and Comprehensive Loss. Increases or decreases in the fair value of the contingent consideration liability can result from changes in passage of time, discount rates, the timing and amount of our revenue estimates, and the timing and expectation of regulatory approvals.

We performed an assessment of the fair value of the contingent consideration and recorded income of $1.8 million and expense of $970,000 in fair value adjustments for the three months ended March 31, 2022 and 2021, respectively, in General, administrative, and marketing expenses on the Condensed Consolidated Statements of Operations and Comprehensive Loss, as a result of this assessment.

‎

The fair value of the contingent consideration component of the Ascyrus acquisition was updated using Level 3 inputs. Changes in fair value of Level 3 assets and liabilities are listed in the tables below (in thousands):


	Contingent Consideration
Balance as of December 31, 2021	$	(49,400)
Change in valuation		1,800
Balance as of March 31, 2022	$	(47,600)

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Cash Equivalents

3 Months Ended

Mar. 31, 2022

Cash Equivalents [Abstract]

Cash Equivalents

3. Cash Equivalents

The following is a summary of cash equivalents (in thousands):


			Unrealized		Estimated
			Holding		Market
March 31, 2022	Cost Basis		Gains		Value
Cash equivalents:
Money market funds	$	10,018	$	--	$	10,018
Total assets	$	10,018	$	--	$	10,018


			Unrealized		Estimated
			Holding		Market
December 31, 2021	Cost Basis		Gains		Value
Cash equivalents:
Money market funds	$	10,015	$	--	$	10,015
Total assets	$	10,015	$	--	$	10,015

There were no gross realized gains or losses on cash equivalents for the three months ended March 31, 2022 and 2021.

Inventories, Net And Deferred Preservation Costs

3 Months Ended

Mar. 31, 2022

Inventories, Net And Deferred Preservation Costs [Abstract]

Inventories, Net And Deferred Preservation Costs

4. Inventories, net and Deferred Preservation Costs

Inventories at March 31, 2022 and December 31, 2021 were comprised of the following (in thousands):


	March 31,		December 31,
	2022		2021
Raw materials and supplies	$	35,075	$	35,780
Work-in-process		11,440		9,712
Finished goods		29,693		31,479
Total inventories, net	$	76,208	$	76,971

To facilitate product usage, we maintain consignment inventory of our On-X heart valves at domestic hospital locations and On-X heart valves and aortic stent grafts at international hospital locations. We retain title and control over this consignment inventory until the device is implanted, at which time we invoice the hospital and recognize revenue. As of March 31, 2022 we had $14.7 million in consignment inventory, with approximately 37% in domestic locations and 63% in international locations. As of December 31, 2021 we had $12.9 million in consignment inventory, with approximately 43% in domestic locations and 57% in international locations.

Total deferred preservation costs were $44.0 million and $42.9 million as of March 31, 2022 and December 31, 2021, respectively.

Inventory and deferred preservation costs obsolescence reserves were $2.7 million and $3.2 million as of March 31, 2022 and December 31, 2021, respectively.

Goodwill And Other Intangible Assets

3 Months Ended

Mar. 31, 2022

Goodwill And Other Intangible Assets [Abstract]

Goodwill And Other Intangible Assets

5. Goodwill and Other Intangible Assets

Indefinite Lived Intangible Assets

As of March 31, 2022 and December 31, 2021 the carrying values of our indefinite lived intangible assets were as follows (in thousands):


	March 31,		December 31,
	2022		2021
Goodwill	$	247,829	$	250,000
In-process R&D		2,164		2,208
Procurement contracts and agreements		2,013		2,013
Trademarks		196		66

We monitor the phases of development of our acquired in-process research and development projects, including the risks associated with further development and the amount and timing of benefits expected to be derived from the completed projects. Incremental costs associated with development are charged to expense as incurred. Capitalized costs are amortized over the estimated useful life of the developed asset once completed. Our in-process research and development projects are reviewed for impairment annually, or more frequently, if events or changes in circumstances indicate that the asset might be impaired. We did not record any impairment of indefinite lived intangible assets during the three months ended March 31, 2022. In-process research and development, procurement contracts and agreements, and trademarks are included in Other intangibles, net on the Condensed Consolidated Balance Sheets as of March 31, 2022 and December 31, 2021.

Based on our experience with similar agreements, we believe that our acquired procurement contracts and agreements have indefinite useful lives, as we expect to continue to renew these contracts for the foreseeable future. We believe that our trademarks have indefinite useful lives as we currently anticipate that our trademarks will contribute to our cash flows indefinitely.

We evaluate our goodwill and non-amortizing intangible assets for impairment on an annual basis during the fourth quarter of the year, and, if necessary, during interim periods if factors indicate that an impairment review is warranted. As of March 31, 2022 we concluded that our assessment of current factors did not indicate that goodwill or non-amortizing intangible assets are more likely than not to be impaired. We will continue to evaluate the recoverability of these non-amortizing intangible assets in future periods as necessary.

As of March 31, 2022 and December 31, 2021 our entire goodwill balance was related to our Medical devices segment.


	Medical Devices Segment
Balance as of December 31, 2021	$	250,000
Foreign currency translation		(2,171)
Balance as of March 31, 2022	$	247,829

Definite Lived Intangible Assets

The definite lived intangible assets balance includes balances related to acquired technology, customer relationships, distribution and manufacturing rights and know-how, patents, and other definite lived intangible assets. As of March 31, 2022 and December 31, 2021 the gross carrying values, accumulated amortization, and approximate amortization period of our definite lived intangible assets were as follows (in thousands):


							Weighted Average
	Gross Carrying		Accumulated		Net Carrying		Useful Life
March 31, 2022	Value		Amortization		Value		(Years)
Acquired technology	$	211,589	$	49,131	$	162,458	17.7
Other intangibles:
Customer lists and relationships		31,108		9,987		21,121	20.5
Distribution and manufacturing rights and know-how		9,652		4,675		4,977	5.0
Patents		4,127		3,153		974	17.0
Other		4,190		1,938		2,252	4.4
Total other intangibles	$	49,077	$	19,753	$	29,324	10.6

							Weighted Average
	Gross Carrying		Accumulated		Net Carrying		Useful Life
December 31, 2021	Value		Amortization		Value		(Years)
Acquired technology	$	213,626	$	46,632	$	166,994	17.7
Other intangibles:
Customer lists and relationships		31,148		9,618		21,530	20.5
Distribution and manufacturing rights and know-how		9,847		4,308		5,539	5.0
Patents		4,083		3,144		939	17.0
Other		3,969		1,762		2,207	4.4
Total other intangibles	$	49,047	$	18,832	$	30,215	10.6

Amortization Expense

The following is a summary of amortization expense as recorded in General, administrative, and marketing expenses on our Condensed Consolidated Statement of Operations and Comprehensive Loss (in thousands):


	Three Months Ended
	March 31,
	2022		2021
Amortization expense	$	4,084	$	4,260

As of March 31, 2022 scheduled amortization of intangible assets for the next five years is as follows (in thousands):


	Remainder
	of 2022		2023		2024		2025		2026		2027		Total
Amortization expense	$	11,625		15,131		14,754		12,785		12,559		12,496	$	79,350

Income Taxes

3 Months Ended

Mar. 31, 2022

Income Taxes [Abstract]

Income Taxes

6. Income Taxes

Income Tax Expense

Our effective income tax rate was an expense of 40% and a benefit of 30% for the three months ended March 31, 2022 and 2021, respectively. Our income tax rate for the three months ended March 31, 2022 was primarily impacted by changes in our valuation allowance against our net deferred tax assets, non-deductible executive compensation, the foreign derived intangible

income deduction, the research and development tax credit, changes in our uncertain tax position liabilities, and tax shortfalls on stock compensation. Our income tax rate for the three months ended March 31, 2021 was primarily impacted by non-deductible executive compensation, changes in our valuation allowance against our net deferred tax assets, changes in our uncertain tax position liabilities, the research and development tax credit, and excess tax benefits on stock compensation.

Deferred Income Taxes

We generate deferred tax assets primarily as a result of capital leases, net operating losses, amortization of research and experimental expenses, excess interest carryforward, stock compensation, and accrued compensation. Our deferred tax liabilities are primarily made up of intangible assets acquired in previous years, capital leases, and unrealized gains and losses.

We maintained a net deferred tax liability of $22.9 million and $26.4 million as of March 31, 2022 and December 31, 2021, respectively. Our valuation allowance against our deferred tax assets was $14.8 million and $13.3 million as of March 31, 2022 and December 31, 2021, respectively, primarily related to net operating loss carryforwards and disallowed excess interest carryforwards.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 21
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32857-109319

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-URI http://asc.fasb.org/extlink&oid=122134291&loc=d3e330215-122817

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 17
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32809-109319

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-Section S99
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-URI http://asc.fasb.org/extlink&oid=122134291&loc=d3e330036-122817

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 14
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32705-109319

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Leases

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Leases

7. Leases

We have operating and finance lease obligations resulting from the lease of land and buildings that comprise our corporate headquarters and various manufacturing facilities; leases related to additional manufacturing, office, and warehouse space; leases on company vehicles; and leases on a variety of office and other equipment.

On January 6, 2021 we executed a modification to extend the lease of our headquarters located in Kennesaw, Georgia. This modification resulted in an increase in the present value of future lease obligations and corresponding right-of-use asset of $23.3 million, using a discount rate of 6.41%.

Information related to leases included in the Condensed Consolidated Balance Sheets is as follows (in thousands, except lease term and discount rate):


Operating leases:		March 31, 2022		December 31, 2021
Operating lease right-of-use assets	$	57,532	$	58,097
Accumulated amortization		(13,167)		(12,383)
Operating lease right-of-use assets, net	$	44,365	$	45,714

Current maturities of operating leases	$	3,362	$	3,149
Non-current maturities of operating leases		43,679		44,869
Total operating lease liabilities	$	47,041	$	48,018

Finance leases:
Property and equipment, at cost	$	6,625	$	6,759
Accumulated amortization		(2,196)		(2,105)
Property and equipment, net	$	4,429	$	4,654

Current maturities of finance leases	$	520	$	528
Non-current maturities of finance leases		4,156		4,374
Total finance lease liabilities	$	4,676	$	4,902

Weighted average remaining lease term (in years):
Operating leases		12.4		12.5
Finance leases		8.6		8.8

Weighted average discount rate:
Operating leases		5.9%		5.8%
Finance leases		2.0%		2.0%

Current maturities of finance leases are included as a component of Other current liabilities on our Condensed Consolidated Balance Sheets. A summary of lease expenses for our finance and operating leases included in General, administrative, and marketing expenses on our Condensed Consolidated Statements of Operations and Comprehensive Income Loss are as follows (in thousands):


	Three Months Ended
	March 31,
		2022		2021
Amortization of property and equipment	$	137	$	154
Interest expense on finance leases		25		29
Total finance lease expense		162		183
Operating lease expense		1,920		1,758
Sublease income		(92)		(124)
Total lease expense	$	1,990	$	1,817

A summary of our cash flow information related to leases is as follows (in thousands):


	Three Months Ended
	March 31,
Cash paid for amounts included in the measurement of lease liabilities:		2022		2021
Operating cash flows for operating leases	$	1,525	$	1,500
Financing cash flows for finance leases		130		144
Operating cash flows for finance leases		24		28

Future minimum lease payments and sublease rental income are as follows (in thousands):


	Finance		Operating		Sublease
	Leases		Leases		Income
Remainder of 2022	$	436	$	4,392	$	214
2023		616		5,630		--
2024		610		6,189		--
2025		587		5,162		--
2026		568		4,767		--
Thereafter		2,272		42,021		--
Total minimum lease payments	$	5,089	$	68,161	$	214
Less amount representing interest		(413)		(21,120)
Present value of net minimum lease payments		4,676		47,041
Less current maturities		(520)		(3,362)
Lease liabilities, less current maturities	$	4,156	$	43,679

Debt

3 Months Ended

Mar. 31, 2022

Debt [Abstract]

Debt

8. Debt

Credit Agreement

On December 1, 2017 we entered into a credit and guaranty agreement for a $255.0 million senior secured credit facility, consisting of a $225.0 million secured term loan facility (the “Term Loan Facility”) and a $30.0 million secured revolving credit facility (the “Revolving Credit Facility” and, together with the Term Loan Facility, the “Credit Agreement”). We and each of our existing domestic subsidiaries (subject to certain exceptions and exclusions) guarantee the obligations under the Credit Agreement (the “Guarantors”). The Credit Agreement is secured by a security interest in substantially all existing and after-acquired real and personal property (subject to certain exceptions and exclusions) of us and the Guarantors.

On June 2, 2021 we entered into an amendment to our Credit Agreement to extend the maturity dates of our Term Loan and Revolving Credit Facility. As part of the amendment, the maturity dates of both our Term Loan and Revolving Credit Facility were each extended by two and one-half years, until June 1, 2027 and June 1, 2025, respectively, subject to earlier springing

maturities triggered if our 4.25% Convertible Senior Notes, described below, remain outstanding on April 1, 2025 and December 31, 2024, respectively. With respect to the Term Loan, if the Convertible Senior Notes remain outstanding on April 1, 2025, the Term Loan’s maturity date will be April 1, 2025, or, if the Convertible Senior Notes’ own maturity date has been extended, the earlier of (i) 91 days prior to the Convertible Senior Notes’ new maturity date and (ii) June 1, 2027. In the case of the Revolving Credit Facility, if the Convertible Senior Notes are still outstanding on December 31, 2024, the Revolving Credit Facility’s maturity date will be either December 31, 2024 or, if the Convertible Senior Notes’ own maturity date has been extended, the earlier of (i) 182 days prior to the Convertible Senior Notes’ new maturity date and (ii) June 1, 2025. Under the amendment, the Term Loan Facility bears interest, at our option, at a floating annual rate equal to either the base rate, plus a margin of 2.50%, or LIBOR, plus a margin of 3.50%. Prior to the amendment, the optional floating annual rate was equal to either the base rate plus a margin of 2.25%, or LIBOR, plus a margin of 3.25%. We paid debt issuance costs of $2.1 million, of which $1.8 million will be amortized over the life of the Term Loan Facility and included in current and long-term debt on the Condensed Consolidated Balance Sheets. The remaining $361,000 of debt issuance costs and $474,000 of non-cash debt extinguishment costs were recorded in Interest expense on the Condensed Consolidated Statements of Operations and Comprehensive Loss.

As discussed in our Annual Report on Form 10-K for the year ended December 31, 2021 the Credit Agreement contains certain customary affirmative and negative covenants, including covenants that limit our ability and the ability of our subsidiaries to, among other things, grant liens, incur debt, dispose of assets, make loans and investments, make acquisitions, make certain restricted payments (including cash dividends), merge or consolidate, change business or accounting or reporting practices, in each case subject to customary exceptions for a credit facility of this size and type. Beginning in 2021 if we repay borrowings under our Revolving Credit Facility to 25% or less, no financial maintenance covenants, including the minimum liquidity covenant and the maximum first lien net leverage ratio covenant, are applicable. We are in compliance with our debt covenants as of March 31, 2022.

Convertible Senior Notes

On June 18, 2020 we issued $100.0 million aggregate principal amount of 4.25% Convertible Senior Notes with a maturity date of July 1, 2025 (the “Convertible Senior Notes”). The net proceeds from this offering, after deducting initial purchasers’ discounts and costs directly related to this offering, were approximately $96.5 million. On January 1, 2021 we adopted ASU 2020-06 and adjusted the carrying balance of the Convertible Senior Notes to notional. The Convertible Senior Notes balance was $100.0 million recorded in Long-term debt on the Condensed Consolidated Balance Sheets as of March 31, 2022. The Convertible Senior Notes may be settled in cash, stock, or a combination thereof, solely at our discretion. The initial conversion rate of the Convertible Senior Notes is 42.6203 shares per $1,000 principal amount, which is equivalent to a conversion price of approximately $23.46 per share, subject to adjustments. We use the if-converted method for assumed conversion of the Convertible Senior Notes for the diluted earnings per share calculation. The fair value and the effective interest rate of the Convertible Senior Notes as of March 31, 2022 was approximately $116.5 million and 5.05%, respectively. The fair value was based on market prices observable for similar instruments and is considered Level 2 in the fair value hierarchy.

The interest expense recognized on the Convertible Senior Notes includes $1.2 million for the aggregate of the contractual coupon interest, and the amortization of the debt issuance costs as of the three months ended March 31, 2022 and 2021. Interest on the Convertible Senior Notes began accruing upon issuance and is payable semi-annually. As of March 31, 2022 there were $2.4 million of unamortized debt issuance costs related to Convertible Senior Notes.

Holders of the Convertible Senior Notes may convert their notes at their option at any time prior to January 1, 2025, but only under the following circumstances: (i) during any calendar quarter commencing after the calendar quarter ending on September 30, 2020 (and only during such calendar quarter), if the last reported sale price of our common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; (ii) during the five business day period after any five consecutive trading day period in which the trading price per $1,000 principal amount of notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day; (iii) we give a notice of redemption with respect to any or all of the notes, at any time prior to the close of business on the second scheduled trading day immediately preceding the redemption date; or (iv) upon the occurrence of specified corporate events. On or after January 1, 2025 until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert their notes at any time, regardless of the foregoing circumstances.

We cannot redeem the Convertible Senior Notes before July 5, 2023. We can redeem them on or after July 5, 2023, in whole or in part, at our option, if the last reported sale price per share of our common stock has been at least 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period

(including the last trading day of such period) ending on, and including, the trading day immediately preceding the date on which we provide notice of redemption. We may redeem for cash all or part of the Convertible Senior Notes at a redemption price equal to 100% of the principal amount of the redeemable Convertible Senior Notes, plus accrued and unpaid interest to, but excluding, the redemption date. No principal payments are due on the Convertible Senior Notes prior to maturity. Other than restrictions relating to certain fundamental changes and consolidations, mergers or asset sales and customary anti-dilution adjustments, the Convertible Senior Notes do not contain any financial covenants and do not restrict us from conducting significant restructuring transactions or issuing or repurchasing any of its other securities.

Loan Balances

The short-term and long-term balances of our term loan and other long-term borrowings were as follows (in thousands):


	March 31,		December 31,
	2022		2021
Term loan balance	$	215,438	$	216,000
Convertible senior notes		100,000		100,000
2.45% Sparkasse Zollernalb (KFW Loan 1)		493		566
1.40% Sparkasse Zollernalb (KFW Loan 2)		971		1,061
Total loan balance		316,902		317,627
Less unamortized loan origination costs		(8,048)		(8,504)
Net borrowings		308,854		309,123
Less short-term loan balance		(1,622)		(1,630)
Long-term loan balance	$	307,232	$	307,493

Interest Expense

Interest expense was $3.9 million and $4.0 million for the three months ended March 31, 2022 and 2021, respectively. Interest expense includes interest on debt and uncertain tax positions in both periods.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

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+ Details

Commitments And Contingencies

3 Months Ended

Mar. 31, 2022

Commitments And Contingencies [Abstract]

Commitments And Contingencies

9. Commitments and Contingencies

Liability Claims

In the normal course of business, we are made aware of adverse events involving our products and tissues. Future adverse events could ultimately give rise to a lawsuit against us, and liability claims may be asserted against us in the future based on past events that we are not aware of at the present time. We maintain claims-made insurance policies to mitigate our financial exposure to product and tissue processing liability claims. Claims-made insurance policies generally cover only those asserted claims and incidents that are reported to the insurance carrier while the policy is in effect. The amounts recorded in these Condensed Consolidated Financial Statements as of March 31, 2022 represent our estimate of the probable losses and anticipated recoveries for incurred but not reported claims related to products sold and services performed prior to the balance sheet date.

Revenue Recognition

3 Months Ended

Mar. 31, 2022

Revenue Recognition [Abstract]

Revenue Recognition

10. Revenue Recognition

Sources of Revenue

We have identified the following revenues disaggregated by revenue source:

Domestic hospitals – direct sales of products and preservation services.

International hospitals – direct sales of products and preservation services.

International distributors – generally these contracts specify a geographic area that the distributor will service, terms and conditions of the relationship, and purchase targets for the next calendar year.

CardioGenesis cardiac laser console trials and sales – CardioGenesis cardiac trialed laser consoles are delivered under separate agreements.

‎

For the three months ended March 31, 2022 and 2021 the sources of revenue were as follows (in thousands):


	Three Months Ended
	March 31,
		2022		2021
	(Unaudited)
Domestic hospitals	$	36,993	$	36,229
International hospitals		28,414		26,128
International distributors		11,064		8,642
CardioGenesis cardiac laser therapy		742		88
Total sources of revenue	$	77,213	$	71,087

Also see segment disaggregation information in Note 13 below.

Contract Balances

We may generate contract assets during the pre-delivery design and manufacturing stage of E-xtra DESIGN ENGINEERING product order fulfillment. We assess the balance related to any arrangements in process and determine if the enforceable right to payment creates a material contract asset requiring disclosure. No material arrangements in process existed as of March 31, 2022 and 2021.

We also incur contract obligations on general customer purchase orders that have been accepted but unfulfilled. Due to the short duration of time between order acceptance and delivery of the related product or service, we have determined that the balance related to these contract obligations is generally immaterial at any point in time. We monitor the value of orders accepted but unfulfilled at the close of each reporting period to determine if disclosure is appropriate. The value of orders accepted but unfulfilled as of March 31, 2022 and 2021 was not material.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Stock Compensation

3 Months Ended

Mar. 31, 2022

Stock Compensation [Abstract]

Stock Compensation

11. Stock Compensation

Overview

We have stock option and stock incentive plans for employees and non-employee Directors that provide for grants of restricted stock awards (“RSAs”), restricted stock units (“RSUs”), performance stock units (“PSUs”), and options to purchase shares of our common stock at exercise prices generally equal to the fair value of such stock at the dates of grant. We also maintain a shareholder-approved Employee Stock Purchase Plan (“ESPP”) for the benefit of our employees. The ESPP allows eligible employees to purchase common stock on a regular basis at the lower of 85% of the market price at the beginning or end of each offering period.

Equity Grants

During the three months ended March 31, 2022 the Compensation Committee of our Board of Directors (the “Committee”) authorized awards from approved stock incentive plans of RSUs and PSUs to certain employees and company officers, which, assuming that performance under the PSUs were to be achieved at target levels, together totaled 452,000 shares and had an aggregate grant date market value of $8.3 million.

During the three months ended March 31, 2021 the Committee authorized awards from approved stock incentive plans of RSUs and PSUs to certain employees, and RSAs and PSUs to certain Company officers, which, assuming that performance under the PSUs were to be achieved at target levels, together totaled 381,000 shares and had an aggregate grant date market value of $9.5 million.

The Committee authorized, from approved stock incentive plans, grants of stock options to purchase a total of 314,000 and 226,000 shares to certain Company officers during the three months ended March 31, 2022 and 2021, respectively. The exercise prices of the options were equal to the closing stock prices on their respective grant dates.

Employees purchased common stock totaling 37,000 and 36,000 shares in the three months ended March 31, 2022 and 2021, respectively, through the ESPP.

Stock Compensation Expense

The following weighted-average assumptions were used to determine the fair value of options and shares purchased under the ESPP:


	Three Months Ended
	March 31, 2022
	Stock Options	ESPP
Expected life	5.0 Years	0.5 Years
Expected stock price volatility	0.40	0.31
Risk-free interest rate	1.89%	0.22%

The following table summarizes total stock compensation expenses prior to the capitalization of amounts into Deferred preservation and Inventory costs (in thousands):


	Three Months Ended
	March 31,
	2022		2021
RSA, RSU, and PSU expense	$	2,768	$	2,050
Stock option and ESPP expense		572		587
Total stock compensation expense	$	3,340	$	2,637

Included in the total stock compensation expense, as applicable in each period, were expenses related to RSAs, RSUs, PSUs, and stock options issued in each respective year, as well as those issued in prior periods that continue to vest during the period, and compensation related to the ESPP. These amounts were recorded as stock compensation expense and were subject to our normal allocation of expenses to inventory costs and deferred preservation costs. We capitalized $174,000 and $157,000 in the three months ended March 31, 2022 and 2021, respectively, of the stock compensation expense into our inventory costs and deferred preservation costs.

‎

Loss Per Common Share

3 Months Ended

Mar. 31, 2022

Loss Per Common Share [Abstract]

Loss Per Common Share

12. Loss Per Common Share

The following table sets forth the computation of basic and diluted loss per common share (in thousands, except per share data):


	Three Months Ended
	March 31,
Basic loss per common share	2022		2021
Net loss	$	(3,389)	$	(3,138)
Net loss allocated to participating securities		18		23
Net loss allocated to common shareholders	$	(3,371)	$	(3,115)

Basic weighted-average common shares outstanding		39,850		38,738
Basic loss per common share	$	(0.08)	$	(0.08)

	Three Months Ended
	March 31,
Diluted loss per common share	2022		2021
Net loss	$	(3,389)	$	(3,138)
Net loss allocated to participating securities		18		23
Net loss allocated to common shareholders	$	(3,371)	$	(3,115)

Basic weighted-average common shares outstanding		39,850		38,738
Diluted weighted-average common shares outstanding		39,850		38,738
Diluted loss per common share	$	(0.08)	$	(0.08)

We excluded stock options from the calculation of diluted weighted-average common shares outstanding if the per share value, including the sum of (i) the exercise price of the options and (ii) the amount of the compensation cost attributed to future services and not yet recognized, was greater than the average market price of the shares because the inclusion of these stock options would be antidilutive to loss per common share. For the three months ended March 31, 2022 and 2021 all stock options and awards were excluded from the calculation of diluted weighted-average common shares outstanding as these would be antidilutive due to the net loss.

Segment Information

3 Months Ended

Mar. 31, 2022

Segment Information [Abstract]

Segment Information

13. Segment Information

We have two reportable segments organized according to our products and services: Medical devices and Preservation services. The Medical devices segment includes external revenues from product sales of aortic stent grafts, surgical sealants, On-X, and other product revenues. Aortic stent grafts include aortic arch stent grafts, abdominal stent grafts, and synthetic vascular grafts. Aortic arch stent grafts include our E-vita Open NEO, E-vita Open Plus, AMDS, NEXUS, E-vita Thoracic 3G, and E-nya products. Abdominal stent grafts include our E-xtra Design Engineering, E-nside, E-tegra, E-ventus BX, and E-liac products. Surgical sealants include BioGlue Surgical Adhesive products. The Preservation Services segment includes external services revenues from the preservation of cardiac and vascular tissues. There are no intersegment revenues.

The primary measure of segment performance, as viewed by our management, is segment gross margin or net external revenues less cost of products and preservation services. We do not segregate assets by segment, therefore, asset information is excluded from the segment disclosures below.

‎

The following table summarizes revenues, cost of products and preservation services, and gross margins for our operating segments (in thousands):


	Three Months Ended
	March 31,
	2022		2021
Revenues:
Medical devices	$	57,542	$	53,345
Preservation services		19,671		17,742
Total revenues		77,213		71,087

Cost of products and preservation services:
Medical devices		17,408		14,911
Preservation services		9,086		8,338
Total cost of products and preservation services		26,494		23,249

Gross margin:
Medical devices		40,134		38,434
Preservation services		10,585		9,404
Total gross margin	$	50,719	$	47,838

The following table summarizes net revenues by product and service (in thousands):


	Three Months Ended
	March 31,
	2022		2021
Products:
Aortic stent grafts	$	25,506	$	20,205
Surgical sealants		15,681		17,828
On-X		14,371		13,095
Other		1,984		2,217
Total products		57,542		53,345

Preservation services		19,671		17,742
Total revenues	$	77,213	$	71,087

‎

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8924-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 34
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8981-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8721-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9031-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 26
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8844-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9038-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9054-108599

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8657-108599

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8721-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-URI http://asc.fasb.org/topic&trid=2134510

+ Details

Basis Of Presentation And Summary Of Significant Accounting Policies (Policy)

3 Months Ended

Mar. 31, 2022

Basis Of Presentation And Summary Of Significant Accounting Policies [Abstract]

New Accounting Standards

Recently Adopted

In August 2020 the Financial Accounting Standards Board (the “FASB”) issued Accounting Standard Update (“ASU”) Update No. 2020-06, Debt - Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging - Contracts in Entity’s Own Equity (Subtopic 815-40) (“ASU 2020-06”). The update simplifies the accounting for convertible instruments by eliminating two accounting models (i.e., the cash conversion model and beneficial conversion feature model) and reducing the number of embedded conversion features that could be recognized separately from the host contract. ASU 2020-06 also enhances transparency and improves disclosures for convertible instruments and earnings per share guidance. On January 1, 2021 we adopted ASU 2020-06 using the modified retrospective approach. See Note 8 for further discussion of convertible debt.

Not Yet Effective

In March 2020 the FASB issued ASU 2020-04, Reference Rate Reform Topic 848 (“ASC 848”). The amendments in this ASU were put forth in response to the market transition from the LIBOR and other interbank offered rates to alternative reference rates. Accounting principles generally accepted in the United States of America require entities to evaluate whether a contract modification, such as the replacement or change of a reference rate, results in the establishment of a new contract or continuation of an existing contract. ASC 848 allows an entity to elect not to apply certain modification accounting requirements to contracts affected by reference rate reform. The standard provides this temporary election through December 31, 2022 and cannot be applied to contract modifications that occur after December 31, 2022. We are in the process of evaluating the effect that the adoption of this standard will have on our financial position and results of operations.

Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2022

Financial Instruments [Abstract]

Summary Of Financial Instruments Measured At Fair Value



March 31, 2022	Level 1		Level 2		Level 3		Total
Cash equivalents:
Money market funds	$	10,018	$	--	$	--	$	10,018
Total assets	$	10,018	$	--	$	--	$	10,018

Long-term liabilities:
Contingent consideration		--		--		(47,600)		(47,600)
Total liabilities	$	--	$	--	$	(47,600)	$	(47,600)


December 31, 2021	Level 1		Level 2		Level 3		Total
Cash equivalents:
Money market funds	$	10,015	$	--	$	--	$	10,015
Total assets	$	10,015	$	--	$	--	$	10,015

Long-term liabilities:
Contingent consideration		--		--		(49,400)		(49,400)
Total liabilities	$	--	$	--	$	(49,400)	$	(49,400)

Reconciliation Of Changes In Fair Value Of Level 3 Liabilities


	Contingent Consideration
Balance as of December 31, 2021	$	(49,400)
Change in valuation		1,800
Balance as of March 31, 2022	$	(47,600)

Cash Equivalents (Tables)

3 Months Ended

Mar. 31, 2022

Cash Equivalents [Abstract]

Summary Of Cash Equivalents And Restricted Securities


			Unrealized		Estimated
			Holding		Market
March 31, 2022	Cost Basis		Gains		Value
Cash equivalents:
Money market funds	$	10,018	$	--	$	10,018
Total assets	$	10,018	$	--	$	10,018


			Unrealized		Estimated
			Holding		Market
December 31, 2021	Cost Basis		Gains		Value
Cash equivalents:
Money market funds	$	10,015	$	--	$	10,015
Total assets	$	10,015	$	--	$	10,015

Inventories, Net And Deferred Preservation Costs (Tables)

3 Months Ended

Mar. 31, 2022

Inventories, Net And Deferred Preservation Costs [Abstract]

Schedule Of Inventories


	March 31,		December 31,
	2022		2021
Raw materials and supplies	$	35,075	$	35,780
Work-in-process		11,440		9,712
Finished goods		29,693		31,479
Total inventories, net	$	76,208	$	76,971

Goodwill And Other Intangible Assets (Tables)

3 Months Ended

Mar. 31, 2022

Goodwill And Other Intangible Assets [Abstract]

Schedule Of Carrying Values Of Indefinite Lived Intangible Assets


	March 31,		December 31,
	2022		2021
Goodwill	$	247,829	$	250,000
In-process R&D		2,164		2,208
Procurement contracts and agreements		2,013		2,013
Trademarks		196		66

Schedule Of Goodwill By Reportable Segment


	Medical Devices Segment
Balance as of December 31, 2021	$	250,000
Foreign currency translation		(2,171)
Balance as of March 31, 2022	$	247,829

Schedule Of Gross Carrying Values, Accumulated Amortization, And Approximate Amortization Period Of Definite Lived Intangible Assets


							Weighted Average
	Gross Carrying		Accumulated		Net Carrying		Useful Life
March 31, 2022	Value		Amortization		Value		(Years)
Acquired technology	$	211,589	$	49,131	$	162,458	17.7
Other intangibles:
Customer lists and relationships		31,108		9,987		21,121	20.5
Distribution and manufacturing rights and know-how		9,652		4,675		4,977	5.0
Patents		4,127		3,153		974	17.0
Other		4,190		1,938		2,252	4.4
Total other intangibles	$	49,077	$	19,753	$	29,324	10.6

							Weighted Average
	Gross Carrying		Accumulated		Net Carrying		Useful Life
December 31, 2021	Value		Amortization		Value		(Years)
Acquired technology	$	213,626	$	46,632	$	166,994	17.7
Other intangibles:
Customer lists and relationships		31,148		9,618		21,530	20.5
Distribution and manufacturing rights and know-how		9,847		4,308		5,539	5.0
Patents		4,083		3,144		939	17.0
Other		3,969		1,762		2,207	4.4
Total other intangibles	$	49,047	$	18,832	$	30,215	10.6

Summary Of Amortization Expense


	Three Months Ended
	March 31,
	2022		2021
Amortization expense	$	4,084	$	4,260

Scheduled Amortization Of Intangible Assets For Next Five Years


	Remainder
	of 2022		2023		2024		2025		2026		2027		Total
Amortization expense	$	11,625		15,131		14,754		12,785		12,559		12,496	$	79,350

Leases (Tables)

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Schedule Of Supplemental Balance Sheet Information Related To Leases


Operating leases:		March 31, 2022		December 31, 2021
Operating lease right-of-use assets	$	57,532	$	58,097
Accumulated amortization		(13,167)		(12,383)
Operating lease right-of-use assets, net	$	44,365	$	45,714

Current maturities of operating leases	$	3,362	$	3,149
Non-current maturities of operating leases		43,679		44,869
Total operating lease liabilities	$	47,041	$	48,018

Finance leases:
Property and equipment, at cost	$	6,625	$	6,759
Accumulated amortization		(2,196)		(2,105)
Property and equipment, net	$	4,429	$	4,654

Current maturities of finance leases	$	520	$	528
Non-current maturities of finance leases		4,156		4,374
Total finance lease liabilities	$	4,676	$	4,902

Weighted average remaining lease term (in years):
Operating leases		12.4		12.5
Finance leases		8.6		8.8

Weighted average discount rate:
Operating leases		5.9%		5.8%
Finance leases		2.0%		2.0%

Summary Of Lease Costs


	Three Months Ended
	March 31,
		2022		2021
Amortization of property and equipment	$	137	$	154
Interest expense on finance leases		25		29
Total finance lease expense		162		183
Operating lease expense		1,920		1,758
Sublease income		(92)		(124)
Total lease expense	$	1,990	$	1,817

Schedule Of Supplemental Cash Flow Information Related To Leases


	Three Months Ended
	March 31,
Cash paid for amounts included in the measurement of lease liabilities:		2022		2021
Operating cash flows for operating leases	$	1,525	$	1,500
Financing cash flows for finance leases		130		144
Operating cash flows for finance leases		24		28

Schedule Of Minimum Lease Payments For Finance, Operating, And Sublease Income Leases


	Finance		Operating		Sublease
	Leases		Leases		Income
Remainder of 2022	$	436	$	4,392	$	214
2023		616		5,630		--
2024		610		6,189		--
2025		587		5,162		--
2026		568		4,767		--
Thereafter		2,272		42,021		--
Total minimum lease payments	$	5,089	$	68,161	$	214
Less amount representing interest		(413)		(21,120)
Present value of net minimum lease payments		4,676		47,041
Less current maturities		(520)		(3,362)
Lease liabilities, less current maturities	$	4,156	$	43,679

Debt (Tables)

3 Months Ended

Mar. 31, 2022

Debt [Abstract]

Schedule Of Short-Term And Long-Term Balances Of Term Loan


	March 31,		December 31,
	2022		2021
Term loan balance	$	215,438	$	216,000
Convertible senior notes		100,000		100,000
2.45% Sparkasse Zollernalb (KFW Loan 1)		493		566
1.40% Sparkasse Zollernalb (KFW Loan 2)		971		1,061
Total loan balance		316,902		317,627
Less unamortized loan origination costs		(8,048)		(8,504)
Net borrowings		308,854		309,123
Less short-term loan balance		(1,622)		(1,630)
Long-term loan balance	$	307,232	$	307,493

Revenue Recognition (Tables)

3 Months Ended

Mar. 31, 2022

Revenue Recognition [Abstract]

Disaggregation Of Revenue


	Three Months Ended
	March 31,
		2022		2021
	(Unaudited)
Domestic hospitals	$	36,993	$	36,229
International hospitals		28,414		26,128
International distributors		11,064		8,642
CardioGenesis cardiac laser therapy		742		88
Total sources of revenue	$	77,213	$	71,087

Stock Compensation (Tables)

3 Months Ended

Mar. 31, 2022

Stock Compensation [Abstract]

Schedule Of Weighted-Average Assumptions Used To Determine The Fair Value Of Options


	Three Months Ended
	March 31, 2022
	Stock Options	ESPP
Expected life	5.0 Years	0.5 Years
Expected stock price volatility	0.40	0.31
Risk-free interest rate	1.89%	0.22%

Summary Of Total Stock Compensation Expenses


	Three Months Ended
	March 31,
	2022		2021
RSA, RSU, and PSU expense	$	2,768	$	2,050
Stock option and ESPP expense		572		587
Total stock compensation expense	$	3,340	$	2,637

Loss Per Common Share (Tables)

3 Months Ended

Mar. 31, 2022

Loss Per Common Share [Abstract]

Computation Of Basic And Diluted (Loss) Income Per Common Share


	Three Months Ended
	March 31,
Basic loss per common share	2022		2021
Net loss	$	(3,389)	$	(3,138)
Net loss allocated to participating securities		18		23
Net loss allocated to common shareholders	$	(3,371)	$	(3,115)

Basic weighted-average common shares outstanding		39,850		38,738
Basic loss per common share	$	(0.08)	$	(0.08)

	Three Months Ended
	March 31,
Diluted loss per common share	2022		2021
Net loss	$	(3,389)	$	(3,138)
Net loss allocated to participating securities		18		23
Net loss allocated to common shareholders	$	(3,371)	$	(3,115)

Basic weighted-average common shares outstanding		39,850		38,738
Diluted weighted-average common shares outstanding		39,850		38,738
Diluted loss per common share	$	(0.08)	$	(0.08)

Segment Information (Tables)

3 Months Ended

Mar. 31, 2022

Segment Information [Abstract]

Revenues, Cost Of Products And Services, And Gross Margins For Operating Segments


	Three Months Ended
	March 31,
	2022		2021
Revenues:
Medical devices	$	57,542	$	53,345
Preservation services		19,671		17,742
Total revenues		77,213		71,087

Cost of products and preservation services:
Medical devices		17,408		14,911
Preservation services		9,086		8,338
Total cost of products and preservation services		26,494		23,249

Gross margin:
Medical devices		40,134		38,434
Preservation services		10,585		9,404
Total gross margin	$	50,719	$	47,838

Summary Of Net Revenues By Product And Service


	Three Months Ended
	March 31,
	2022		2021
Products:
Aortic stent grafts	$	25,506	$	20,205
Surgical sealants		15,681		17,828
On-X		14,371		13,095
Other		1,984		2,217
Total products		57,542		53,345

Preservation services		19,671		17,742
Total revenues	$	77,213	$	71,087

Financial Instruments (Narrative) (Details) $ in Thousands	3 Months Ended
Financial Instruments (Narrative) (Details) $ in Thousands	Mar. 31, 2022 USD ($) item	Mar. 31, 2021 USD ($)	Sep. 02, 2020 USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Income (expense) on revaluation of contingent consideration	$ 1,800	$ (970)
Ascyrus Medical LLC [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Percentage of outstanding equity acquired			100.00%
Maximum amount of future consideration payment			$ 120,000
Income (expense) on revaluation of contingent consideration	$ 1,800	$ (970)
Ascyrus Medical LLC [Member] \| Measurement Input, Discount Rate [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration, measurement input \| item	10

Financial Instruments (Summary Of Financial Instruments Measured At Fair Value) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Total assets	$ 10,018	$ 10,015
Long-term contingent consideration	(47,600)	(49,400)
Total liabilities	(47,600)	(49,400)
Money Market Funds [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents	10,018	10,015
Level 1 [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Total assets	10,018	10,015
Level 1 [Member] \| Money Market Funds [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents	10,018	10,015
Level 2 [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Total assets
Long-term contingent consideration
Total liabilities
Level 2 [Member] \| Money Market Funds [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents
Level 3 [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Total assets
Long-term contingent consideration	(47,600)	(49,400)
Total liabilities	(47,600)	(49,400)
Level 3 [Member] \| Money Market Funds [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents

Financial Instruments (Reconciliation Of Changes In Fair Value Of Level 3 Liabilities) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Financial Instruments [Abstract]
Beginning balance, Contingent Consideration	$ (49,400)
Income (expense) on revaluation of contingent consideration	1,800	$ (970)
Ending balance, Contingent Consideration	$ (47,600)

Cash Equivalents (Narrative) (Details) - USD ($)	3 Months Ended
Cash Equivalents (Narrative) (Details) - USD ($)	Mar. 31, 2022	Mar. 31, 2021
Cash Equivalents [Abstract]
Gross realized gains or losses on cash equivalents	$ 0	$ 0

Cash Equivalents (Summary Of Cash Equivalents And Restricted Securities) (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021	Mar. 31, 2021	Dec. 31, 2020
Cash and Cash Equivalents [Line Items]
Cash Equivalents, Cost Basis	$ 51,408	$ 55,010	$ 57,102	$ 61,958
Cost Basis	10,018	10,015
Unrealized Holding Gains
Estimated Market Value	10,018	10,015
Money Market Funds [Member]
Cash and Cash Equivalents [Line Items]
Cash Equivalents, Cost Basis	10,018	10,015
Unrealized Holding Gains
Cash Equivalents, Estimated Market Value	$ 10,018	$ 10,015

Inventories, Net And Deferred Preservation Costs (Narrative) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Inventory [Line Items]
Consignment inventory	$ 14,700	$ 12,900
Deferred preservation costs, net	43,964	42,863
Inventory valuation reserve	$ 2,700	$ 3,200
Domestic [Member]
Inventory [Line Items]
Consignment inventory percentage	37.00%	43.00%
Foreign [Member]
Inventory [Line Items]
Consignment inventory percentage	63.00%	57.00%

Inventories, Net And Deferred Preservation Costs (Schedule Of Inventories) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Inventories, Net And Deferred Preservation Costs [Abstract]
Raw materials and supplies	$ 35,075	$ 35,780
Work-in-process	11,440	9,712
Finished goods	29,693	31,479
Total inventories, net	$ 76,208	$ 76,971

Goodwill And Other Intangible Assets (Schedule Of Carrying Values Of Indefinite Lived Intangible Assets) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Indefinite-lived Intangible Assets [Line Items]
Goodwill	$ 247,829	$ 250,000
In-Process R&D [Member]
Indefinite-lived Intangible Assets [Line Items]
Total indefinite lived intangible assets	2,164	2,208
Procurement Contracts And Agreements [Member]
Indefinite-lived Intangible Assets [Line Items]
Total indefinite lived intangible assets	2,013	2,013
Trademarks [Member]
Indefinite-lived Intangible Assets [Line Items]
Total indefinite lived intangible assets	$ 196	$ 66

Goodwill And Other Intangible Assets (Schedule Of Goodwill By Reportable Segment) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022 USD ($)
Goodwill And Other Intangible Assets [Abstract]
Beginning balance	$ 250,000
Foreign currency translation	(2,171)
Ending balance	$ 247,829

Goodwill And Other Intangible Assets (Schedule Of Gross Carrying Values, Accumulated Amortization, And Approximate Amortization Period Of Definite Lived Intangible Assets) (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Net Carrying Value	$ 162,458	$ 166,994
Acquired Technology [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	211,589	213,626
Accumulated Amortization	49,131	46,632
Net Carrying Value	$ 162,458	$ 166,994
Weighted Average Useful Life (Years)	17 years 8 months 12 days	17 years 8 months 12 days
Other Intangibles [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 49,077	$ 49,047
Accumulated Amortization	19,753	18,832
Net Carrying Value	$ 29,324	$ 30,215
Weighted Average Useful Life (Years)	10 years 7 months 6 days	10 years 7 months 6 days
Customer Lists And Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 31,108	$ 31,148
Accumulated Amortization	9,987	9,618
Net Carrying Value	$ 21,121	$ 21,530
Weighted Average Useful Life (Years)	20 years 6 months	20 years 6 months
Distribution And Manufacturing Rights And Know-How [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 9,652	$ 9,847
Accumulated Amortization	4,675	4,308
Net Carrying Value	$ 4,977	$ 5,539
Weighted Average Useful Life (Years)	5 years	5 years
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 4,127	$ 4,083
Accumulated Amortization	3,153	3,144
Net Carrying Value	$ 974	$ 939
Weighted Average Useful Life (Years)	17 years	17 years
Other [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 4,190	$ 3,969
Accumulated Amortization	1,938	1,762
Net Carrying Value	$ 2,252	$ 2,207
Weighted Average Useful Life (Years)	4 years 4 months 24 days	4 years 4 months 24 days

Goodwill And Other Intangible Assets (Summary Of Amortization Expense) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Goodwill And Other Intangible Assets [Abstract]
Amortization expense	$ 4,084	$ 4,260

Goodwill And Other Intangible Assets (Scheduled Amortization Of Intangible Assets For Next Five Years) (Details) $ in Thousands	Mar. 31, 2022 USD ($)
Goodwill And Other Intangible Assets [Abstract]
Remainder of 2022	$ 11,625
2023	15,131
2024	14,754
2025	12,785
2026	12,559
2027	12,496
Total	$ 79,350

Income Taxes (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended
Income Taxes (Narrative) (Details) - USD ($) $ in Millions	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Income Taxes [Abstract]
Effective income tax rate	40.00%	30.00%
Net deferred tax liability	$ 22.9		$ 26.4
Valuation allowances against deferred tax assets	$ 14.8		$ 13.3

Leases (Narrative) (Details)	Jan. 06, 2021
Leases [Abstract]
Discount rate	6.41%

Leases (Schedule Of Supplemental Balance Sheet Information Related To Leases) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021	Jan. 06, 2021
Leases [Abstract]
Operating lease right-of-use assets	$ 57,532	$ 58,097
Accumulated amortization	(13,167)	(12,383)
Operating lease right-of-use assets, net	44,365	45,714	$ 23,300
Current maturities of operating leases	3,362	3,149
Non-current maturities of operating leases	43,679	44,869
Total operating lease liabilities	47,041	48,018
Finance leases, Property and equipment, at cost	6,625	6,759
Finance leases, Accumulated amortization	(2,196)	(2,105)
Finance leases, property and equipment, net	4,429	4,654
Current maturities of finance leases	520	528
Non-current maturities of finance leases	4,156	4,374
Total finance lease liabilities	$ 4,676	$ 4,902
Weighted average remaining lease term (in years): Operating leases	12 years 4 months 24 days	12 years 6 months
Weighted average remaining lease term (in years): Finance leases	8 years 7 months 6 days	8 years 9 months 18 days
Weighted average discount rate: Operating leases	5.90%	5.80%
Weighted average discount rate: Finance leases	2.00%	2.00%

Leases (Summary Of Lease Costs) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Leases [Abstract]
Amortization of property and equipment	$ 137	$ 154
Interest expense on finance leases	25	29
Total finance lease expense	162	183
Operating lease expense	1,920	1,758
Sublease income	(92)	(124)
Total lease expense	$ 1,990	$ 1,817

Leases (Schedule Of Supplemental Cash Flow Information Related To Leases) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Leases [Abstract]
Operating cash flows for operating leases	$ 1,525	$ 1,500
Financing cash flows for finance leases	130	144
Operating cash flows for finance leases	$ 24	$ 28

Leases (Schedule Of Minimum Lease Payments For Finance, Operating, And Sublease Income Leases) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Finance Leases, Remainder of 2022	$ 436
Finance Leases, 2023	616
Finance Leases, 2024	610
Finance Leases, 2025	587
Finance Leases, 2026	568
Finance Leases, Thereafter	2,272
Finance Leases, Total minimum lease payments	5,089
Finance Leases, Less amount representing interest	(413)
Finance Leases, Present value of net minimum lease payments	4,676	$ 4,902
Finance Leases, Less current maturities	(520)	(528)
Finance lease obligations, less current maturities	4,156	4,374
Operating Leases, Remainder of 2022	4,392
Operating Leases, 2023	5,630
Operating Leases, 2024	6,189
Operating Leases, 2025	5,162
Operating Leases, 2026	4,767
Operating Leases, Thereafter	42,021
Operating Leases, Total minimum lease payments	68,161
Operating Leases, Less amount representing interest	(21,120)
Operating Leases, Present value of net minimum lease payments	47,041	48,018
Operating Leases, Less current maturities	(3,362)	(3,149)
Operating Leases, Lease liabilities, less current maturities	43,679	$ 44,869
Sublease Income, Remainder of 2022	214
Sublease Income	$ 214

Debt (Narrative) (Details)				3 Months Ended
Debt (Narrative) (Details)	Jun. 02, 2021 USD ($)	Jun. 01, 2021	Jun. 18, 2020 USD ($) $ / shares	Mar. 31, 2022 USD ($) item	Mar. 31, 2021 USD ($)	Dec. 31, 2021 USD ($)	Dec. 01, 2017 USD ($)
Line of Credit Facility [Line Items]
Interest expense				$ 3,900,000	$ 4,000,000.0
Long-term debt				$ 308,854,000		$ 309,123,000
Interest Expense [Member]
Line of Credit Facility [Line Items]
Debt issuance costs	$ 361,000
Debt extinguishment costs	474,000
Amended Credit Agreement Two [Member]
Line of Credit Facility [Line Items]
Revolving credit facility, percentage repaid for no covenants				25.00%
2.45% Sparkasse Zollernalb (KFW Loan 1) [Member]
Line of Credit Facility [Line Items]
Interest rate on amounts borrowed				2.45%
1.40% Sparkasse Zollernalb (KFW Loan 2) [Member]
Line of Credit Facility [Line Items]
Interest rate on amounts borrowed				1.40%
Convertible Senior Notes [Member]
Line of Credit Facility [Line Items]
Face value			$ 100,000,000.0
Interest rate on amounts borrowed			4.25%
Maturity date				Jul. 01, 2025
Proceeds from issuance of convertible debt			$ 96,500,000
Conversion ratio			42.6203
Conversion principal amount			$ 1,000
Conversion price \| $ / shares			$ 23.46
Debt fair value				$ 116,500,000
Effective interest rate				5.05%
Interest expense				$ 1,200,000	$ 1,200,000
Unamortized debt issuance costs				$ 2,400,000
Convertible Senior Notes [Member] \| Circumstance I [Member]
Line of Credit Facility [Line Items]
Conversion trading day threshold \| item				20
Conversion consecutive trading day threshold \| item				30
Conversion percentage of stock price threshold				130.00%
Convertible Senior Notes [Member] \| Circumstance II [Member]
Line of Credit Facility [Line Items]
Conversion principal amount				$ 1,000
Conversion trading day threshold \| item				5
Conversion consecutive trading day threshold \| item				5
Conversion percentage of stock price threshold				98.00%
Convertible Senior Notes [Member] \| Circumstance After July 5, 2023 [Member]
Line of Credit Facility [Line Items]
Conversion trading day threshold \| item				20
Conversion consecutive trading day threshold \| item				30
Conversion percentage of stock price threshold				130.00%
Conversion percentage of principal amount				100.00%
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Credit facility aggregate commitments							$ 30,000,000.0
Secured Debt [Member]
Line of Credit Facility [Line Items]
Credit facility aggregate commitments							$ 255,000,000.0
Term Loan [Member] \| Amended Credit Agreement Two [Member] \| Circumstance I [Member]
Line of Credit Facility [Line Items]
Debt instrument, extension circumstance period				91 days
Term Loan [Member] \| Amended Credit Agreement Two [Member] \| Circumstance II [Member]
Line of Credit Facility [Line Items]
Debt instrument, extension circumstance period				182 days
Term Loan [Member] \| Base Rate [Member]
Line of Credit Facility [Line Items]
Credit facility margin		2.25%
Term Loan [Member] \| Base Rate [Member] \| Amended Credit Agreement Two [Member]
Line of Credit Facility [Line Items]
Credit facility margin				2.50%
Term Loan [Member] \| LIBOR [Member]
Line of Credit Facility [Line Items]
Credit facility margin		3.25%
Term Loan [Member] \| LIBOR [Member] \| Amended Credit Agreement Two [Member]
Line of Credit Facility [Line Items]
Credit facility margin				3.50%
Revolving Credit Facility And Term Loan [Member]
Line of Credit Facility [Line Items]
Debt issuance costs	2,100,000
Amortization of the debt issuance costs	$ 1,800,000
Revolving Credit Facility And Term Loan [Member] \| Amended Credit Agreement Two [Member]
Line of Credit Facility [Line Items]
Debt instrument, extension period	2 years 6 months
Revolving Credit Facility And Term Loan [Member] \| Convertible Senior Notes [Member] \| Amended Credit Agreement Two [Member]
Line of Credit Facility [Line Items]
Interest rate on amounts borrowed				4.25%
Accounting Standards Update 2020-06 [Member] \| Cumulative Effect, Period of Adoption, Adjustment [Member] \| Convertible Senior Notes [Member]
Line of Credit Facility [Line Items]
Long-term debt				$ 100,000,000.0

Debt (Schedule Of Short-Term And Long-Term Balances Of Term Loan) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021	Dec. 01, 2017
Debt Instrument [Line Items]
Total loan balance	$ 316,902	$ 317,627
Less unamortized loan origination costs	(8,048)	(8,504)
Total loan balance	308,854	309,123
Less short-term loan balance, net	(1,622)	(1,630)
Long-term loan balance, net	307,232	307,493
2.45% Sparkasse Zollernalb (KFW Loan 1) [Member]
Debt Instrument [Line Items]
Total loan balance	$ 493	566
Interest rate on amounts borrowed	2.45%
1.40% Sparkasse Zollernalb (KFW Loan 2) [Member]
Debt Instrument [Line Items]
Total loan balance	$ 971	1,061
Interest rate on amounts borrowed	1.40%
Term Loan [Member]
Debt Instrument [Line Items]
Total loan balance	$ 215,438	216,000	$ 225,000
Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Total loan balance	$ 100,000	$ 100,000

Revenue Recognition (Disaggregation Of Revenue) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Disaggregation of Revenue [Line Items]
Total sources of revenue	$ 77,213	$ 71,087
Domestic Hospitals [Member]
Disaggregation of Revenue [Line Items]
Total sources of revenue	36,993	36,229
International Hospitals [Member]
Disaggregation of Revenue [Line Items]
Total sources of revenue	28,414	26,128
International Distributors [Member]
Disaggregation of Revenue [Line Items]
Total sources of revenue	11,064	8,642
Cardiogenesis [Member]
Disaggregation of Revenue [Line Items]
Total sources of revenue	$ 742	$ 88

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130545-203045

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+ Details

Stock Compensation (Narrative) (Details) - USD ($)	3 Months Ended
Stock Compensation (Narrative) (Details) - USD ($)	Mar. 31, 2022	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Capitalized stock compensation expense	$ 174,000	$ 157,000
ESPP Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
ESPP, percentage of market price for eligible employees	85.00%
Employees purchased common stock, shares	37,000	36,000
RSUs And PSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized awards from approved stock incentive plans	452,000
Aggregate grant date market value	$ 8,300,000
RSAs, RSUs, And PSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized awards from approved stock incentive plans		381,000
Aggregate grant date market value		$ 9,500,000
Officers [Member] \| Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Grants of stock options	314,000	226,000

Stock Compensation (Schedule Of Weighted-Average Assumptions Used To Determine The Fair Value Of Options) (Details)	3 Months Ended
	Mar. 31, 2022
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected life	5 years
Expected stock price volatility	0.40%
Risk-free interest rate	1.89%
ESPP Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected life	6 months
Expected stock price volatility	0.31%
Risk-free interest rate	0.22%

Stock Compensation (Summary Of Total Stock Compensation Expenses) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock compensation expense	$ 3,340	$ 2,637
RSA, RSU, And PSU Expense [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock compensation expense	2,768	2,050
Stock Option And ESPP Option Expense [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock compensation expense	$ 572	$ 587

Loss Per Common Share (Computation Of Basic And Diluted (Loss) Income Per Common Share) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Basic loss per common share
Net loss	$ (3,389)	$ (3,138)
Net loss allocated to participating securities	18	23
Net loss allocated to common shareholders	$ (3,371)	$ (3,115)
Basic weighted-average common shares outstanding	39,850	38,738
Basic loss per common share	$ (0.08)	$ (0.08)
Diluted loss per common share
Net loss	$ (3,389)	$ (3,138)
Net loss allocated to participating securities	18	23
Net loss allocated to common shareholders	$ (3,371)	$ (3,115)
Basic weighted-average common shares outstanding	39,850	38,738
Diluted weighted-average common shares outstanding	39,850	38,738
Diluted loss per common share	$ (0.08)	$ (0.08)

Segment Information (Narrative) (Details)	3 Months Ended
Segment Information (Narrative) (Details)	Mar. 31, 2022 USD ($) segment	Mar. 31, 2021 USD ($)
Segment Reporting Information [Line Items]
Number of reportable segments \| segment	2
Revenues	$ 77,213,000	$ 71,087,000
Intersegment Eliminations [Member]
Segment Reporting Information [Line Items]
Revenues	0	0
Operating Segments [Member] \| Medical Devices [Member]
Segment Reporting Information [Line Items]
Revenues	$ 57,542,000	$ 53,345,000

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Segment Information (Revenues, Cost Of Products And Services, And Gross Margins For Operating Segments) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Total revenues	$ 77,213	$ 71,087
Total cost of products and preservation services	26,494	23,249
Total gross margin	50,719	47,838
Operating Segments [Member] \| Medical Devices [Member]
Segment Reporting Information [Line Items]
Total revenues	57,542	53,345
Total cost of products and preservation services	17,408	14,911
Total gross margin	40,134	38,434
Operating Segments [Member] \| Preservation Services [Member]
Segment Reporting Information [Line Items]
Total revenues	19,671	17,742
Total cost of products and preservation services	9,086	8,338
Total gross margin	$ 10,585	$ 9,404

- Definition

Aggregate revenue less cost of goods and services sold or operating expenses directly attributable to the revenue generation activity.

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Segment Information (Summary Of Net Revenues By Product And Service) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Product Information [Line Items]
Total revenues	$ 77,213	$ 71,087
Products [Member]
Product Information [Line Items]
Total revenues	57,542	53,345
Aortic Stent Grafts [Member]
Product Information [Line Items]
Total revenues	25,506	20,205
Surgical Sealants [Member]
Product Information [Line Items]
Total revenues	15,681	17,828
On-X [Member]
Product Information [Line Items]
Total revenues	14,371	13,095
Other [Member]
Product Information [Line Items]
Total revenues	1,984	2,217
Preservation Services [Member]
Product Information [Line Items]
Total revenues	19,671	17,742
Operating Segments [Member] \| Products [Member]
Product Information [Line Items]
Total revenues	$ 57,542	$ 53,345

- Definition

+ References

+ Details

1. Basis of Presentation and Summary of Significant Accounting Policies