0000784199-22-000189 | 10-Q | XBRL Viewer

Print Document View Excel Document

Cover - shares	9 Months Ended
Cover - shares	Sep. 30, 2022	Oct. 28, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
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		40,329,481
Entity Central Index Key	0000784199
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Amendment Flag	false

Condensed Consolidated Statements of Operations and Comprehensive (Loss) Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenues:
Total revenues	$ 76,838	$ 72,207	$ 234,391	$ 219,442
Cost of products and preservation services:
Total cost of products and preservation services	28,094	24,418	82,756	73,302
Gross margin	48,744	47,789	151,635	146,140
Operating expenses:
General, administrative, and marketing	41,051	39,053	118,989	118,521
Research and development	11,799	9,972	30,575	26,086
Total operating expenses	52,850	49,025	149,564	144,607
Gain from sale of non-financial assets	0	(15,923)	0	(15,923)
Operating (loss) income	(4,106)	14,687	2,071	17,456
Interest expense	4,805	4,100	12,854	12,995
Interest income	(40)	(18)	(86)	(60)
Other expense, net	3,661	2,661	7,564	3,261
(Loss) income before income taxes	(12,532)	7,944	(18,261)	1,260
Income tax expense (benefit)	1,181	(2,638)	3,100	(4,006)
Net (loss) income	$ (13,713)	$ 10,582	$ (21,361)	$ 5,266
(Loss) income per share:
(Loss) income per share, basic (in usd per share)	$ (0.34)	$ 0.27	$ (0.53)	$ 0.13
(Loss) income per share, diluted (in usd per share)	$ (0.34)	$ 0.26	$ (0.53)	$ 0.13
Weighted-average common shares outstanding:
Weighted-average common shares outstanding, basic (in shares)	40,115	39,086	39,999	38,924
Weighted-average common shares outstanding, diluted (in shares)	40,115	44,453	39,999	39,496
Net (loss) income	$ (13,713)	$ 10,582	$ (21,361)	$ 5,266
Other comprehensive loss:
Foreign currency translation adjustments	(16,895)	(5,010)	(35,466)	(12,327)
Comprehensive (loss) income	(30,608)	5,572	(56,827)	(7,061)
Products
Revenues:
Total revenues	55,248	53,107	171,726	162,528
Cost of products and preservation services:
Total cost of products and preservation services	17,743	15,503	53,381	46,592
Preservation services
Revenues:
Total revenues	21,590	19,100	62,665	56,914
Cost of products and preservation services:
Total cost of products and preservation services	$ 10,351	$ 8,915	$ 29,375	$ 26,710

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 37,572	$ 55,010
Trade receivables, net	57,159	53,019
Other receivables	7,880	5,086
Inventories, net	73,044	76,971
Deferred preservation costs, net	45,483	42,863
Prepaid expenses and other	16,851	14,748
Total current assets	237,989	247,697
Goodwill	234,773	250,000
Acquired technology, net	148,060	166,994
Operating lease right-of-use assets, net	41,320	45,714
Property and equipment, net	36,286	37,521
Other intangibles, net	31,112	34,502
Deferred income taxes	6,103	2,357
Other assets	7,088	8,267
Total assets	742,731	793,052
Current liabilities:
Accounts payable	10,721	10,395
Accrued compensation	11,079	13,163
Accrued expenses	10,088	7,687
Taxes payable	5,293	3,634
Accrued procurement fees	2,302	3,689
Current maturities of operating leases	3,061	3,149
Current portion of long-term debt	1,562	1,630
Other liabilities	1,886	1,606
Total current liabilities	45,992	44,953
Long-term debt	306,674	307,493
Contingent consideration	44,800	49,400
Non-current maturities of operating leases	40,915	44,869
Non-current finance lease obligation	3,450	4,374
Deferred income taxes	34,058	28,799
Deferred compensation liability	5,082	5,952
Other liabilities	6,652	6,484
Total liabilities	487,623	492,324
Commitments and contingencies
Shareholders' equity:
Preferred stock	0	0
Common stock (issued shares of 41,816 in 2022 and 41,397 in 2021)	418	414
Additional paid-in capital	334,077	322,874
Retained (deficit) earnings	(19,386)	1,975
Accumulated other comprehensive loss	(45,353)	(9,887)
Treasury stock, at cost, 1,487 shares as of September 30, 2022 and December 31, 2021	(14,648)	(14,648)
Total shareholders' equity	255,108	300,728
Total liabilities and shareholders' equity	$ 742,731	$ 793,052

Condensed Consolidated Balance Sheets (Parenthetical) - shares	Sep. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Common stock, shares issued (in shares)	41,816,000	41,397,000
Treasury stock at cost, shares (in shares)	1,487,000	1,487,000

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Net cash flows from operating activities:
Net (loss) income	$ (21,361)	$ 5,266
Adjustments to reconcile net (loss) income to net cash from operating activities:
Depreciation and amortization	17,016	18,008
Non-cash compensation	9,189	7,471
Non-cash lease expense	5,656	5,566
Deferred income taxes	5,097	(8,128)
Write-down of inventories and deferred preservation costs	3,116	3,987
Non-cash interest expense	1,372	2,025
Change in fair value of contingent consideration	(4,600)	4,970
Gain from sale of non-financial assets	0	(15,923)
Other	151	678
Changes in operating assets and liabilities:
Prepaid expenses and other assets	(1,788)	(2,268)
Accounts payable, accrued expenses, and other liabilities	(2,103)	65
Inventories and deferred preservation costs	(5,781)	(16,986)
Receivables	(10,900)	(8,032)
Net cash flows used in operating activities	(4,936)	(3,301)
Net cash flows from investing activities:
Acquisition of intangible assets	(1,123)	(726)
Capital expenditures	(6,924)	(10,524)
Proceeds from sale of non-financial assets, net	0	19,000
Other	0	722
Net cash flows (used in) provided by investing activities	(8,047)	8,472
Net cash flows from financing activities:
Proceeds from exercise of stock options and issuance of common stock	3,344	3,531
Redemption and repurchase of stock to cover tax withholdings	(1,791)	(1,898)
Repayment of term loan	(2,033)	(2,397)
Payment of debt issuance costs	0	(2,219)
Other	(300)	(439)
Net cash flows used in financing activities	(780)	(3,422)
Effect of exchange rate changes on cash and cash equivalents	(3,675)	1,418
(Decrease) increase in cash and cash equivalents	(17,438)	3,167
Cash and cash equivalents beginning of period	55,010	61,958
Cash and cash equivalents end of period	$ 37,572	$ 65,125

Condensed Consolidated Statements of Shareholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Cumulative Effect, Period of Adoption, Adjustment	Common Stock	Additional Paid-In Capital	Additional Paid-In Capital Cumulative Effect, Period of Adoption, Adjustment	Retained Deficit	Retained Deficit Cumulative Effect, Period of Adoption, Adjustment	Accumulated Other Comprehensive Loss	Treasury Stock
Beginning balance (in shares) at Dec. 31, 2020			40,394
Beginning balance at Dec. 31, 2020	$ 328,713	$ (19,639)	$ 404	$ 316,192	$ (16,426)	$ 20,022	$ (3,213)	$ 6,743
Beginning balance, treasury stock (in shares) at Dec. 31, 2020									(1,487)
Beginning balance, treasury stock at Dec. 31, 2020									$ (14,648)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	5,266					5,266
Other comprehensive loss	(12,327)							(12,327)
Equity compensation (in shares)			252
Equity compensation	7,895		$ 3	7,892
Exercise of options (in shares)			158
Exercise of options	1,922		$ 1	1,921
Employee stock purchase plan (in shares)			87
Employee stock purchase plan	1,609		$ 1	1,608
Redemption and repurchase of stock to cover tax withholdings (in shares)			(75)
Redemption and repurchase of stock to cover tax withholdings	(1,898)		$ (1)	(1,897)
Ending balance (in shares) at Sep. 30, 2021			40,816
Ending balance at Sep. 30, 2021	311,541		$ 408	309,290		22,075		(5,584)
Ending balance, treasury stock (in shares) at Sep. 30, 2021									(1,487)
Ending balance, treasury stock at Sep. 30, 2021									$ (14,648)
Beginning balance (in shares) at Jun. 30, 2021			40,742
Beginning balance at Jun. 30, 2021	301,835		$ 407	305,157		11,493		(574)
Beginning balance, treasury stock (in shares) at Jun. 30, 2021									(1,487)
Beginning balance, treasury stock at Jun. 30, 2021									$ (14,648)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	10,582					10,582
Other comprehensive loss	(5,010)							(5,010)
Equity compensation (in shares)			8
Equity compensation	2,991		$ 1	2,990
Exercise of options (in shares)			18
Exercise of options	191			191
Employee stock purchase plan (in shares)			50
Employee stock purchase plan	1,019			1,019
Redemption and repurchase of stock to cover tax withholdings (in shares)			(2)
Redemption and repurchase of stock to cover tax withholdings	(67)			(67)
Ending balance (in shares) at Sep. 30, 2021			40,816
Ending balance at Sep. 30, 2021	311,541		$ 408	309,290		22,075		(5,584)
Ending balance, treasury stock (in shares) at Sep. 30, 2021									(1,487)
Ending balance, treasury stock at Sep. 30, 2021									$ (14,648)
Beginning balance (in shares) at Dec. 31, 2021			41,397
Beginning balance at Dec. 31, 2021	$ 300,728		$ 414	322,874		1,975		(9,887)
Beginning balance, treasury stock (in shares) at Dec. 31, 2021	(1,487)								(1,487)
Beginning balance, treasury stock at Dec. 31, 2021	$ (14,648)								$ (14,648)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	(21,361)					(21,361)
Other comprehensive loss	(35,466)							(35,466)
Equity compensation (in shares)			269
Equity compensation	9,654		$ 2	9,652
Exercise of options (in shares)			149
Exercise of options	1,765		$ 2	1,763
Employee stock purchase plan (in shares)			95
Employee stock purchase plan	1,579		$ 1	1,578
Redemption and repurchase of stock to cover tax withholdings (in shares)			(94)
Redemption and repurchase of stock to cover tax withholdings	(1,791)		$ (1)	(1,790)
Ending balance (in shares) at Sep. 30, 2022			41,816
Ending balance at Sep. 30, 2022	$ 255,108		$ 418	334,077		(19,386)		(45,353)
Ending balance, treasury stock (in shares) at Sep. 30, 2022	(1,487)								(1,487)
Ending balance, treasury stock at Sep. 30, 2022	$ (14,648)								$ (14,648)
Beginning balance (in shares) at Jun. 30, 2022			41,744
Beginning balance at Jun. 30, 2022	281,509		$ 417	329,871		(5,673)		(28,458)
Beginning balance, treasury stock (in shares) at Jun. 30, 2022									(1,487)
Beginning balance, treasury stock at Jun. 30, 2022									$ (14,648)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	(13,713)					(13,713)
Other comprehensive loss	(16,895)							(16,895)
Equity compensation (in shares)			7
Equity compensation	3,233			3,233
Exercise of options (in shares)			9
Exercise of options	85			85
Employee stock purchase plan (in shares)			58
Employee stock purchase plan	941		$ 1	940
Redemption and repurchase of stock to cover tax withholdings (in shares)			(2)
Redemption and repurchase of stock to cover tax withholdings	(52)			(52)
Ending balance (in shares) at Sep. 30, 2022			41,816
Ending balance at Sep. 30, 2022	$ 255,108		$ 418	$ 334,077		$ (19,386)		$ (45,353)
Ending balance, treasury stock (in shares) at Sep. 30, 2022	(1,487)								(1,487)
Ending balance, treasury stock at Sep. 30, 2022	$ (14,648)								$ (14,648)

Basis of Presentation and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Summary of Significant Accounting Policies	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 and nine months ended, September 30, 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 and nine months ended September 30, 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 and nine months ended September 30, 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 9 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.

Sale of PerClot	9 Months Ended
Sale of PerClot	Sep. 30, 2022
Discontinued Operations and Disposal Groups [Abstract]
Sale of PerClot	Sale of PerClot Overview On July 28, 2021 we entered into an asset purchase agreement and other ancillary agreements related to the sale of PerClot®, a polysaccharide hemostatic agent used in surgery (“PerClot”), to a subsidiary of Baxter International, Inc. (“Baxter”) and an agreement to terminate all of our material agreements with Starch Medical, Inc. (“SMI”) related to PerClot (collectively the “Baxter Transaction”). Under the terms of the Baxter Transaction, Baxter will pay an aggregate of up to $60.8 million in consideration (we will receive up to $45.8 million and SMI will receive up to $15.0 million), consisting of (i) $25.0 million at closing, of which $6.0 million was paid to SMI; (ii) up to $25.0 million upon our receipt of Premarket Approval (“PMA”) approval from the US Food and Drug Administration (the “FDA”) for PerClot and our transfer of the PMA to Baxter, of which up to $6.0 million is payable to SMI, subject to certain reductions for delay in PMA approval; and (iii) up to $10.0 million upon Baxter’s achievement of certain cumulative worldwide net sales of PerClot prior to December 31, 2026 and December 31, 2027, of which up to $3.0 million is payable to SMI. In addition, at the conclusion of our manufacturing and supply services for Baxter, Baxter will pay $780,000 upon transfer of our PerClot manufacturing equipment. Under the terms of the Baxter Transaction, we will continue to provide to Baxter certain transition and manufacturing and supply services relating to the sale of SMI PerClot outside of the US and manufacture and supply of PerClot to Baxter post PMA approval. Accounting for the Transaction Upon closing of the Baxter Transaction, we received $25.0 million from Baxter and paid $6.0 million to SMI. We derecognized intangible assets with a carrying value of $1.6 million and wrote-off $1.5 million of prepaid royalties previously recorded on our Condensed Consolidated Balance Sheets related to PerClot. Under the terms of the agreement, Baxter acquired intellectual property related to our development efforts for PerClot. We recorded a pre-tax gain of $15.9 million, included as Gain from sale of non-financial assets within the Condensed Consolidated Statements of Operations for the three and nine months ended September 30, 2021. The PerClot product line was included as part of our Medical Devices segment.

Financial Instruments

9 Months Ended

Sep. 30, 2022

Fair Value Disclosures [Abstract]

Financial Instruments

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


September 30, 2022	Level 1		Level 2		Level 3		Total
Cash equivalents:
Money market funds	$	10,051	$	—	$	—	$	10,051
Total assets	$	10,051	$	—	$	—	$	10,051

Long-term liabilities:
Contingent consideration	—		—		(44,800)		(44,800)
Total liabilities	$	—	$	—	$	(44,800)	$	(44,800)


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 of up to $100.0 million to the former shareholders of Ascyrus upon the achievement of certain milestones and the sales-based additional earn-out.

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 13% and estimated future achievement of milestone dates between 2025 and 2026 to calculate the fair value of contingent consideration as of September 30, 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) Income. 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 expense of $400,000 and income of $4.6 million for the three and nine months ended September 30, 2022, respectively, and expense of $700,000 and $5.0 million for the three and nine months ended September 30, 2021, respectively, in General, administrative, and marketing expenses on the Condensed Consolidated Statements of Operations and Comprehensive (Loss) Income, 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	4,600
Balance as of September 30, 2022	$	(44,800)

- 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

9 Months Ended

Sep. 30, 2022

Cash and Cash Equivalents [Abstract]

Cash Equivalents

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


September 30, 2022	Cost Basis		Unrealized Holding Gains		Estimated Market Value
Cash equivalents:
Money market funds	$	10,051	$	—	$	10,051
Total assets	$	10,051	$	—	$	10,051


December 31, 2021	Cost Basis		Unrealized Holding Gains		Estimated Market 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 and nine months ended September 30, 2022 and 2021.

Inventories, net and Deferred Preservation Costs

9 Months Ended

Sep. 30, 2022

Inventory Disclosure [Abstract]

Inventories, net and Deferred Preservation Costs

Inventories at September 30, 2022 and December 31, 2021 were comprised of the following (in thousands):


	September 30, 2022		December 31, 2021
Raw materials and supplies	$	35,206	$	35,780
Work-in-process	11,976		9,712
Finished goods	25,862		31,479
Total inventories, net	$	73,044	$	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 September 30, 2022 we had $13.2 million in consignment inventory, with approximately 39% in domestic locations and 61% 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 $45.5 million and $42.9 million as of September 30, 2022 and December 31, 2021, respectively.

Inventory and deferred preservation costs obsolescence reserves were $1.9 million and $3.2 million as of September 30, 2022 and December 31, 2021, respectively.

Goodwill and Other Intangible Assets

9 Months Ended

Sep. 30, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangible Assets

Indefinite Lived Intangible Assets

As of September 30, 2022 and December 31, 2021 the carrying values of our indefinite lived intangible assets were as follows (in thousands):


	September 30, 2022		December 31, 2021
Goodwill	$	234,773	$	250,000
In-process R&D	1,901		2,208
Procurement contracts and agreements	2,013		2,013
Trademarks	247		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 and nine months ended September 30, 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 September 30, 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 September 30, 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 September 30, 2022 and December 31, 2021 the carrying value of goodwill, all of which is related to our Medical devices segment, is as follows (in thousands):


	Medical Devices Segment
Balance as of December 31, 2021	$	250,000
Foreign currency translation	(15,227)
Balance as of September 30, 2022	$	234,773

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 September 30, 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, except weighted average useful life):


September 30, 2022	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Useful Life (Years)
Acquired technology	$	190,108	$	42,048	$	148,060	18.3
Other intangibles:
Customer lists and relationships	30,868		10,677		20,191		20.6
Distribution and manufacturing rights and know-how	8,476		4,900		3,576		5.0
Patents	4,171		3,168		1,003		17.0
Other	4,325		2,144		2,181		4.5
Total other intangibles	$	47,840	$	20,889	$	26,951	10.8


December 31, 2021	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Useful Life (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) Income (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Amortization expense	$	3,686	$	4,203	$	11,675	$	12,701

As of September 30, 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	$	3,593	14,174	13,822	12,070	11,842	11,748	$	67,249

Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes Income Tax Expense Our effective income tax rate was an expense of 9% and 17% for the three and nine months ended September 30, 2022, respectively, as compared to a benefit of 33% and 318% for the three and nine months ended September 30, 2021, respectively. Our income tax rate for the three and nine months ended September 30, 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 and nine months ended September 30, 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 finance leases, net operating losses, amortization of research and development expenses, excess interest carryforward, stock compensation, and accrued compensation. Our deferred tax liabilities are primarily made up of intangible assets acquired in previous years, finance leases, and unrealized gains and losses. We maintained a net deferred tax liability of $28.0 million and $26.4 million as of September 30, 2022 and December 31, 2021, respectively. Our valuation allowance against our deferred tax assets was $17.8 million and $13.3 million as of September 30, 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
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-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
-Topic 740
-SubTopic 270
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6424409&loc=d3e44925-109338

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-URI http://asc.fasb.org/topic&trid=2144680

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=6424122&loc=d3e41874-109331

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Leases

9 Months Ended

Sep. 30, 2022

Leases [Abstract]

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%.

On June 1, 2021 we began occupancy of the newly constructed addition to our leased international headquarters located in Hechingen, Germany. This lease resulted in an increase in the present value of future lease obligations and corresponding right-of-use asset of $9.8 million, using a discount rate of 5.46%.

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


Operating leases:	September 30, 2022		December 31, 2021
Operating lease right-of-use assets	$	55,405	$	58,097
Accumulated amortization	(14,085)		(12,383)
Operating lease right-of-use assets, net	$	41,320	$	45,714

Current maturities of operating leases	$	3,061	$	3,149
Non-current maturities of operating leases	40,915		44,869
Total operating lease liabilities	$	43,976	$	48,018

Finance leases:
Property and equipment, at cost	$	5,861	$	6,759
Accumulated amortization	(2,166)		(2,105)
Property and equipment, net	$	3,695	$	4,654

Current maturities of finance leases	$	469	$	528
Non-current maturities of finance leases	3,450		4,374
Total finance lease liabilities	$	3,919	$	4,902

Weighted average remaining lease term (in years):
Operating leases	12.2		12.5
Finance leases	8.1		8.8

Weighted average discount rate:
Operating leases	5.9%		5.8%
Finance leases	2.1%		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 (Loss) Income is as follows (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Amortization of property and equipment	$	127	$	190	$	395	$	500
Interest expense on finance leases	22		27		69		85
Total finance lease expense	149		217		464		585
Operating lease expense	1,853		1,989		5,656		5,566
Sublease income	(92)		(92)		(275)		(308)
Total lease expense	$	1,910	$	2,114	$	5,845	$	5,843

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


	Nine Months Ended September 30,
Cash paid for amounts included in the measurement of lease liabilities:	2022		2021
Operating cash flows for operating leases	$	4,939	$	4,536
Financing cash flows for finance leases	346		446
Operating cash flows for finance leases	62		82

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


	Finance Leases		Operating Leases		Sublease Income
Remainder of 2022	$	120	$	660	$	31
2023	549		5,624		—
2024	545		6,252		—
2025	525		5,173		—
2026	508		4,719		—
Thereafter	2,000		40,986		—
Total minimum lease payments	$	4,247	$	63,414	$	31
Less amount representing interest	(328)		(19,438)
Present value of net minimum lease payments	3,919		43,976
Less current maturities	(469)		(3,061)
Lease liabilities, less current maturities	$	3,450	$	40,915

Debt

9 Months Ended

Sep. 30, 2022

Debt Disclosure [Abstract]

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) Income.

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 September 30, 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 September 30, 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 September 30, 2022 was approximately $92.3 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 and $3.7 million for the three and nine months ended September 30, 2022, respectively, and $1.2 million and $3.7 million for the three and nine months ended September 30, 2021, respectively, related to the aggregate of the contractual coupon interest, and the amortization of the debt issuance costs. Interest on the Convertible Senior Notes began accruing upon issuance and is payable semi-annually. As of September 30, 2022 there were $2.0 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):


	September 30, 2022		December 31, 2021
Term loan balance	$	214,313	$	216,000
Convertible senior notes	100,000		100,000
2.45% Sparkasse Zollernalb (KFW Loan 1)	325		566
1.40% Sparkasse Zollernalb (KFW Loan 2)	731		1,061
Total loan balance	315,369		317,627
Less unamortized loan origination costs	(7,133)		(8,504)
Net borrowings	308,236		309,123
Less short-term loan balance	(1,562)		(1,630)
Long-term loan balance	$	306,674	$	307,493

Interest Expense

Interest expense was $4.8 million and $12.9 million for the three and nine months ended September 30, 2022, respectively, as compared to $4.1 million and $13.0 million for the three and nine months ended September 30, 2021, respectively.

- 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

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-URI http://asc.fasb.org/topic&trid=2208564

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (h)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (g)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1E
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495348-112611

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (i)
-URI http://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

+ Details

Commitments and Contingencies	9 Months Ended
Commitments and Contingencies	Sep. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	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 September 30, 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. PROACT Xa Clinical Trial Termination On September 23, 2022 we announced that we were stopping the PROACT Xa clinical trial as recommended by the trial's independent Data and Safety Monitoring Board. The PROACT Xa clinical trial was a prospective, randomized, trial designed to determine if patients with On-X mechanical aortic valves could be maintained safely and effectively on apixaban rather than on warfarin. As a result of PROACT Xa's early termination, we recorded $4.7 million of termination and wind-down expenses that are included in Research and development operating expenses on the Condensed Consolidated Statements of Operations and Comprehensive (Loss) Income for the three and nine months ended September 30, 2022. The majority of these costs include future administrative costs that will be incurred during the fourth quarter of 2022 and the first quarter of 2023, as well as the estimated cost of clinical drugs purchased for patients participating in the study that are not expected to be recovered.

Revenue Recognition

9 Months Ended

Sep. 30, 2022

Revenue from Contract with Customer [Abstract]

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 and nine months ended September 30, 2022 and 2021 the sources of revenue were as follows (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Domestic hospitals	$	40,842	$	36,129	$	117,343	$	111,291
International hospitals	24,119		25,458		79,768		79,219
International distributors	11,469		10,544		34,685		28,694
CardioGenesis cardiac laser therapy	408		76		2,595		238
Total sources of revenue	$	76,838	$	72,207	$	234,391	$	219,442

Also see segment disaggregation information in Note 14 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 September 30, 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 September 30, 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
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 10
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130551-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130556-203045

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 9
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130550-203045

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

+ Details

Stock Compensation

9 Months Ended

Sep. 30, 2022

Share-based Payment Arrangement [Abstract]

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 nine months ended September 30, 2022 the Compensation Committee of our Board of Directors (the “Committee”) authorized awards from approved stock incentive plans of RSAs to non-employee directors and 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 520,000 shares and had an aggregate grant date fair value of $9.7 million.

During the nine months ended September 30, 2021 the Committee authorized awards from approved stock incentive plans of RSAs to non-employee directors, RSUs 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 494,000 shares and had an aggregate grant date fair value of $12.5 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 nine months ended September 30, 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 58,000 and 95,000 shares in the three and nine months ended September 30, 2022, respectively, as compared to 51,000 and 87,000 shares in the three and nine months ended September 30, 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
September 30, 2022

Nine Months Ended
September 30, 2022

Stock Options

ESPP

Stock
Options

ESPP

Expected life

N/A

0.5 Years

5.0 Years

0.5 Years

Expected stock price volatility

N/A

0.49

0.40

0.31

Risk-free interest rate

N/A

2.52%

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 September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
RSA, RSU, and PSU expense	$	2,622	$	2,465	$	7,860	$	6,211
Stock option and ESPP expense	611		525		1,794		1,684
Total stock compensation expense	$	3,233	$	2,990	$	9,654	$	7,895

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 $144,000 and $465,000 in the three and nine months ended September 30, 2022, respectively, and $115,000 and $424,000 in the three and nine months ended September 30, 2021, respectively, of the stock compensation expense into our inventory costs and deferred preservation costs.

(Loss) Earnings Per Common Share

9 Months Ended

Sep. 30, 2022

Earnings Per Share [Abstract]

(Loss) Earnings Per Common Share

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


	Three Months Ended September 30,				Nine Months Ended September 30,
Basic (loss) income per common share	2022		2021		2022		2021
Net (loss) income	$	(13,713)	$	10,582	$	(21,361)	$	5,266
Net loss (income) allocated to participating securities	70		(63)		109		(34)
Net (loss) income allocated to common shareholders	$	(13,643)	$	10,519	$	(21,252)	$	5,232

Basic weighted-average common shares outstanding	40,115		39,086		39,999		38,924
Basic (loss) income per common share	$	(0.34)	$	0.27	$	(0.53)	$	0.13


	Three Months Ended September 30,				Nine Months Ended September 30,
Diluted (loss) income per common share	2022		2021		2022		2021
Net (loss) income	$	(13,713)	$	10,582	$	(21,361)	$	5,266
Net loss (income) allocated to participating securities	70		(55)		109		(34)
Net loss attributable to convertible senior notes	—		919		—		—
Net (loss) income allocated to common shareholders	$	(13,643)	$	11,446	$	(21,252)	$	5,232

Basic weighted-average common shares outstanding	40,115		39,086		39,999		38,924
Effect of dilutive stock options and awards	—		505		—		572
Effect of convertible senior notes	—		4,862		—		—
Diluted weighted-average common shares outstanding	40,115		44,453		39,999		39,496
Diluted (loss) income per common share	$	(0.34)	$	0.26	$	(0.53)	$	0.13

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 and nine months ended September 30, 2022 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. For the three and nine months ended September 30, 2021 539,000 and 517,000 of potential common shares relating to stock options, respectively, were antidilutive and excluded from the calculation of diluted weighted-average common shares outstanding. We excluded 4,860,685 of potential common shares related to our Convertible Senior Notes calculated under the if-converted method, as these shares would be antidilutive for the nine months ended September 30, 2021.

Segment Information

9 Months Ended

Sep. 30, 2022

Segment Reporting [Abstract]

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 September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Revenues:
Medical devices	$	55,248	$	53,107	$	171,726	$	162,528
Preservation services	21,590		19,100		62,665		56,914
Total revenues	76,838		72,207		234,391		219,442

Cost of products and preservation services:
Medical devices	17,743		15,503		53,381		46,592
Preservation services	10,351		8,915		29,375		26,710
Total cost of products and preservation services	28,094		24,418		82,756		73,302

Gross margin:
Medical devices	37,505		37,604		118,345		115,936
Preservation services	11,239		10,185		33,290		30,204
Total gross margin	$	48,744	$	47,789	$	151,635	$	146,140

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Products:
Aortic stent grafts	$	19,674	$	20,896	$	69,013	$	62,165
Surgical sealants	17,374		16,544		49,022		52,236
On-X	16,456		14,022		47,082		41,843
Other	1,744		1,645		6,609		6,284
Total products	55,248		53,107		171,726		162,528

Preservation services	21,590		19,100		62,665		56,914
Total revenues	$	76,838	$	72,207	$	234,391	$	219,442

- 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 (Policies)	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
New Accounting Standards	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 9 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)

9 Months Ended

Sep. 30, 2022

Fair Value Disclosures [Abstract]

Summary of Financial Instruments Measured at Fair Value

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


September 30, 2022	Level 1		Level 2		Level 3		Total
Cash equivalents:
Money market funds	$	10,051	$	—	$	—	$	10,051
Total assets	$	10,051	$	—	$	—	$	10,051

Long-term liabilities:
Contingent consideration	—		—		(44,800)		(44,800)
Total liabilities	$	—	$	—	$	(44,800)	$	(44,800)


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

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	4,600
Balance as of September 30, 2022	$	(44,800)

Cash Equivalents (Tables)

9 Months Ended

Sep. 30, 2022

Cash and Cash Equivalents [Abstract]

Summary of Cash Equivalents and Restricted Securities

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


September 30, 2022	Cost Basis		Unrealized Holding Gains		Estimated Market Value
Cash equivalents:
Money market funds	$	10,051	$	—	$	10,051
Total assets	$	10,051	$	—	$	10,051


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

Inventories, Net And Deferred Preservation Costs (Tables)

9 Months Ended

Sep. 30, 2022

Inventory Disclosure [Abstract]

Schedule of Inventories

Inventories at September 30, 2022 and December 31, 2021 were comprised of the following (in thousands):


	September 30, 2022		December 31, 2021
Raw materials and supplies	$	35,206	$	35,780
Work-in-process	11,976		9,712
Finished goods	25,862		31,479
Total inventories, net	$	73,044	$	76,971

Goodwill and Other Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Carrying Values of Indefinite Lived Intangible Assets

As of September 30, 2022 and December 31, 2021 the carrying values of our indefinite lived intangible assets were as follows (in thousands):


	September 30, 2022		December 31, 2021
Goodwill	$	234,773	$	250,000
In-process R&D	1,901		2,208
Procurement contracts and agreements	2,013		2,013
Trademarks	247		66

Schedule of Goodwill by Reportable Segment

As of September 30, 2022 and December 31, 2021 the carrying value of goodwill, all of which is related to our Medical devices segment, is as follows (in thousands):


	Medical Devices Segment
Balance as of December 31, 2021	$	250,000
Foreign currency translation	(15,227)
Balance as of September 30, 2022	$	234,773

Schedule of Gross Carrying Values, Accumulated Amortization, and Approximate Amortization Period of Definite Lived Intangible Assets

As of September 30, 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, except weighted average useful life):


September 30, 2022	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Useful Life (Years)
Acquired technology	$	190,108	$	42,048	$	148,060	18.3
Other intangibles:
Customer lists and relationships	30,868		10,677		20,191		20.6
Distribution and manufacturing rights and know-how	8,476		4,900		3,576		5.0
Patents	4,171		3,168		1,003		17.0
Other	4,325		2,144		2,181		4.5
Total other intangibles	$	47,840	$	20,889	$	26,951	10.8


December 31, 2021	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Useful Life (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 September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Amortization expense	$	3,686	$	4,203	$	11,675	$	12,701

Scheduled Amortization of Intangible Assets for Next Five Years

As of September 30, 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	$	3,593	14,174	13,822	12,070	11,842	11,748	$	67,249

Leases (Tables)

9 Months Ended

Sep. 30, 2022

Leases [Abstract]

Schedule of Supplemental Balance Sheet Information Related to Leases

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


Operating leases:	September 30, 2022		December 31, 2021
Operating lease right-of-use assets	$	55,405	$	58,097
Accumulated amortization	(14,085)		(12,383)
Operating lease right-of-use assets, net	$	41,320	$	45,714

Current maturities of operating leases	$	3,061	$	3,149
Non-current maturities of operating leases	40,915		44,869
Total operating lease liabilities	$	43,976	$	48,018

Finance leases:
Property and equipment, at cost	$	5,861	$	6,759
Accumulated amortization	(2,166)		(2,105)
Property and equipment, net	$	3,695	$	4,654

Current maturities of finance leases	$	469	$	528
Non-current maturities of finance leases	3,450		4,374
Total finance lease liabilities	$	3,919	$	4,902

Weighted average remaining lease term (in years):
Operating leases	12.2		12.5
Finance leases	8.1		8.8

Weighted average discount rate:
Operating leases	5.9%		5.8%
Finance leases	2.1%		2.0%

Summary of Lease Costs

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 (Loss) Income is as follows (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Amortization of property and equipment	$	127	$	190	$	395	$	500
Interest expense on finance leases	22		27		69		85
Total finance lease expense	149		217		464		585
Operating lease expense	1,853		1,989		5,656		5,566
Sublease income	(92)		(92)		(275)		(308)
Total lease expense	$	1,910	$	2,114	$	5,845	$	5,843

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


	Nine Months Ended September 30,
Cash paid for amounts included in the measurement of lease liabilities:	2022		2021
Operating cash flows for operating leases	$	4,939	$	4,536
Financing cash flows for finance leases	346		446
Operating cash flows for finance leases	62		82

Lessee, Operating Lease, Liability, Maturity

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


	Finance Leases		Operating Leases		Sublease Income
Remainder of 2022	$	120	$	660	$	31
2023	549		5,624		—
2024	545		6,252		—
2025	525		5,173		—
2026	508		4,719		—
Thereafter	2,000		40,986		—
Total minimum lease payments	$	4,247	$	63,414	$	31
Less amount representing interest	(328)		(19,438)
Present value of net minimum lease payments	3,919		43,976
Less current maturities	(469)		(3,061)
Lease liabilities, less current maturities	$	3,450	$	40,915

Finance Lease, Liability, Fiscal Year Maturity

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


	Finance Leases		Operating Leases		Sublease Income
Remainder of 2022	$	120	$	660	$	31
2023	549		5,624		—
2024	545		6,252		—
2025	525		5,173		—
2026	508		4,719		—
Thereafter	2,000		40,986		—
Total minimum lease payments	$	4,247	$	63,414	$	31
Less amount representing interest	(328)		(19,438)
Present value of net minimum lease payments	3,919		43,976
Less current maturities	(469)		(3,061)
Lease liabilities, less current maturities	$	3,450	$	40,915

Debt (Tables)

9 Months Ended

Sep. 30, 2022

Debt Disclosure [Abstract]

Schedule of Short-Term and Long-Term Balances of Term Loan

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


	September 30, 2022		December 31, 2021
Term loan balance	$	214,313	$	216,000
Convertible senior notes	100,000		100,000
2.45% Sparkasse Zollernalb (KFW Loan 1)	325		566
1.40% Sparkasse Zollernalb (KFW Loan 2)	731		1,061
Total loan balance	315,369		317,627
Less unamortized loan origination costs	(7,133)		(8,504)
Net borrowings	308,236		309,123
Less short-term loan balance	(1,562)		(1,630)
Long-term loan balance	$	306,674	$	307,493

Revenue Recognition (Tables)

9 Months Ended

Sep. 30, 2022

Revenue from Contract with Customer [Abstract]

Disaggregation of Revenue

For the three and nine months ended September 30, 2022 and 2021 the sources of revenue were as follows (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Domestic hospitals	$	40,842	$	36,129	$	117,343	$	111,291
International hospitals	24,119		25,458		79,768		79,219
International distributors	11,469		10,544		34,685		28,694
CardioGenesis cardiac laser therapy	408		76		2,595		238
Total sources of revenue	$	76,838	$	72,207	$	234,391	$	219,442

Stock Compensation (Tables)

9 Months Ended

Sep. 30, 2022

Share-based Payment Arrangement [Abstract]

Schedule of Weighted-Average Assumptions Used to Determine the Fair Value of Options

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

Three Months Ended
September 30, 2022

Nine Months Ended
September 30, 2022

Stock Options

ESPP

Stock
Options

ESPP

Expected life

N/A

0.5 Years

5.0 Years

0.5 Years

Expected stock price volatility

N/A

0.49

0.40

0.31

Risk-free interest rate

N/A

2.52%

1.89%

0.22%

Summary of Total Stock Compensation Expenses

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 September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
RSA, RSU, and PSU expense	$	2,622	$	2,465	$	7,860	$	6,211
Stock option and ESPP expense	611		525		1,794		1,684
Total stock compensation expense	$	3,233	$	2,990	$	9,654	$	7,895

(Loss) Earnings Per Common Share (Tables)

9 Months Ended

Sep. 30, 2022

Earnings Per Share [Abstract]

Computation of Basic and Diluted (Loss) Income Per Common Share

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


	Three Months Ended September 30,				Nine Months Ended September 30,
Basic (loss) income per common share	2022		2021		2022		2021
Net (loss) income	$	(13,713)	$	10,582	$	(21,361)	$	5,266
Net loss (income) allocated to participating securities	70		(63)		109		(34)
Net (loss) income allocated to common shareholders	$	(13,643)	$	10,519	$	(21,252)	$	5,232

Basic weighted-average common shares outstanding	40,115		39,086		39,999		38,924
Basic (loss) income per common share	$	(0.34)	$	0.27	$	(0.53)	$	0.13


	Three Months Ended September 30,				Nine Months Ended September 30,
Diluted (loss) income per common share	2022		2021		2022		2021
Net (loss) income	$	(13,713)	$	10,582	$	(21,361)	$	5,266
Net loss (income) allocated to participating securities	70		(55)		109		(34)
Net loss attributable to convertible senior notes	—		919		—		—
Net (loss) income allocated to common shareholders	$	(13,643)	$	11,446	$	(21,252)	$	5,232

Basic weighted-average common shares outstanding	40,115		39,086		39,999		38,924
Effect of dilutive stock options and awards	—		505		—		572
Effect of convertible senior notes	—		4,862		—		—
Diluted weighted-average common shares outstanding	40,115		44,453		39,999		39,496
Diluted (loss) income per common share	$	(0.34)	$	0.26	$	(0.53)	$	0.13

Segment Information (Tables)

9 Months Ended

Sep. 30, 2022

Segment Reporting [Abstract]

Revenues, Cost of Products and Services, and Gross Margins for Operating Segments

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Revenues:
Medical devices	$	55,248	$	53,107	$	171,726	$	162,528
Preservation services	21,590		19,100		62,665		56,914
Total revenues	76,838		72,207		234,391		219,442

Cost of products and preservation services:
Medical devices	17,743		15,503		53,381		46,592
Preservation services	10,351		8,915		29,375		26,710
Total cost of products and preservation services	28,094		24,418		82,756		73,302

Gross margin:
Medical devices	37,505		37,604		118,345		115,936
Preservation services	11,239		10,185		33,290		30,204
Total gross margin	$	48,744	$	47,789	$	151,635	$	146,140

Summary of Net Revenues by Product and Service

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Products:
Aortic stent grafts	$	19,674	$	20,896	$	69,013	$	62,165
Surgical sealants	17,374		16,544		49,022		52,236
On-X	16,456		14,022		47,082		41,843
Other	1,744		1,645		6,609		6,284
Total products	55,248		53,107		171,726		162,528

Preservation services	21,590		19,100		62,665		56,914
Total revenues	$	76,838	$	72,207	$	234,391	$	219,442

Sale of PerClot (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
Sale of PerClot (Details) - USD ($) $ in Thousands	Jul. 28, 2021	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of assets				$ 0	$ 19,000
Gain from sale of non-financial assets		$ 0	$ 15,923	$ 0	$ 15,923
Per Clot
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration for sale of assets	$ 45,800
Derecognition of intangible assets	1,600
Write off of intangible assets	1,500
Gain from sale of non-financial assets	15,900
Per Clot \| Transfer Of Perclot Manufacturing Equipment
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contingent consideration receivable	780
Per Clot \| Artivion Inc. And Starch Medical Inc.
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration for sale of assets	60,800
Proceeds from sale of assets	25,000
Per Clot \| Artivion Inc. And Starch Medical Inc. \| Pma Approval
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contingent consideration receivable	25,000
Per Clot \| Artivion Inc. And Starch Medical Inc. \| Baxter Achievement Of Worldwide Sales
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contingent consideration receivable	10,000
Per Clot \| Starch Medical Inc.
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration for sale of assets	15,000
Proceeds from sale of assets	6,000
Per Clot \| Starch Medical Inc. \| Pma Approval
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contingent consideration receivable	6,000
Per Clot \| Starch Medical Inc. \| Baxter Achievement Of Worldwide Sales
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contingent consideration receivable	$ 3,000

Financial Instruments (Summary Of Financial Instruments Measured At Fair Value) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents:	$ 10,051	$ 10,015
Total assets	10,051	10,015
Contingent consideration	(44,800)	(49,400)
Total liabilities	(44,800)	(49,400)
Money market funds
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents:	10,051	10,015
Level 1
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Total assets	10,051	10,015
Contingent consideration	0	0
Total liabilities	0	0
Level 1 \| Money market funds
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents:	10,051	10,015
Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Total assets	0	0
Contingent consideration	0	0
Total liabilities	0	0
Level 2 \| Money market funds
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents:	0	0
Level 3
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Total assets	0	0
Contingent consideration	(44,800)	(49,400)
Total liabilities	(44,800)	(49,400)
Level 3 \| Money market funds
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash equivalents:	$ 0	$ 0

Financial Instruments (Narrative) (Details) $ in Thousands	3 Months Ended		9 Months Ended
Financial Instruments (Narrative) (Details) $ in Thousands	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 02, 2020 USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Increase (decrease) in fair value of contingent consideration			$ (4,600)	$ 4,970
Ascyrus Medical LLC
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					$ 100,000
Increase (decrease) in fair value of contingent consideration	$ (400)	$ (700)	$ 4,600	$ (5,000)
Ascyrus Medical LLC \| Measurement Input, Discount Rate
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration, measurement input	0.13		0.13

Financial Instruments (Reconciliation Of Changes In Fair Value Of Level 3 Liabilities) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Contingent Consideration
Beginning balance	$ (49,400)
Change in valuation	4,600	$ (4,970)
Ending balance	$ (44,800)

Cash Equivalents (Summary Of Cash Equivalents And Restricted Securities) (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Cash and Cash Equivalents [Line Items]
Cost Basis	$ 10,051	$ 10,015
Unrealized Holding Gains	0	0
Estimated Market Value	10,051	10,015
Money market funds
Cash and Cash Equivalents [Line Items]
Cost Basis	10,051	10,015
Unrealized Holding Gains	0	0
Estimated Market Value	$ 10,051	$ 10,015

Cash Equivalents (Narrative) (Details) - USD ($)	3 Months Ended		9 Months Ended
Cash Equivalents (Narrative) (Details) - USD ($)	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Cash and Cash Equivalents [Abstract]
Gross realized gains or losses on cash equivalents	$ 0	$ 0	$ 0	$ 0

Inventories, net and Deferred Preservation Costs (Schedule Of Inventories) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Inventory Disclosure [Abstract]
Raw materials and supplies	$ 35,206	$ 35,780
Work-in-process	11,976	9,712
Finished goods	25,862	31,479
Total inventories, net	$ 73,044	$ 76,971

Inventories, net and Deferred Preservation Costs (Narrative) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Inventory [Line Items]
Consignment inventory	$ 13,200	$ 12,900
Deferred preservation costs, net	45,483	42,863
Inventory valuation reserve	$ 1,900	$ 3,200
Domestic
Inventory [Line Items]
Consignment inventory percentage	39.00%	43.00%
International
Inventory [Line Items]
Consignment inventory percentage	61.00%	57.00%

Goodwill and Other Intangible Assets (Schedule of Carrying Values of Indefinite Lived Intangible Assets) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Indefinite-lived Intangible Assets [Line Items]
Goodwill	$ 234,773	$ 250,000
In-process R&D
Indefinite-lived Intangible Assets [Line Items]
Total indefinite-lived intangible assets	1,901	2,208
Procurement contracts and agreements
Indefinite-lived Intangible Assets [Line Items]
Total indefinite-lived intangible assets	2,013	2,013
Trademarks
Indefinite-lived Intangible Assets [Line Items]
Total indefinite-lived intangible assets	$ 247	$ 66

Goodwill and Other Intangible Assets (Schedule of Goodwill by Reportable Segment) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 250,000
Foreign currency translation	(15,227)
Ending balance	$ 234,773

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	9 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Net Carrying Value	$ 148,060	$ 166,994
Acquired technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	190,108	213,626
Accumulated Amortization	42,048	46,632
Net Carrying Value	$ 148,060	$ 166,994
Weighted Average Useful Life (Years)	18 years 3 months 18 days	17 years 8 months 12 days
Other intangibles:
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 47,840	$ 49,047
Accumulated Amortization	20,889	18,832
Net Carrying Value	$ 26,951	$ 30,215
Weighted Average Useful Life (Years)	10 years 9 months 18 days	10 years 7 months 6 days
Customer lists and relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 30,868	$ 31,148
Accumulated Amortization	10,677	9,618
Net Carrying Value	$ 20,191	$ 21,530
Weighted Average Useful Life (Years)	20 years 7 months 6 days	20 years 6 months
Distribution and manufacturing rights and know-how
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 8,476	$ 9,847
Accumulated Amortization	4,900	4,308
Net Carrying Value	$ 3,576	$ 5,539
Weighted Average Useful Life (Years)	5 years	5 years
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 4,171	$ 4,083
Accumulated Amortization	3,168	3,144
Net Carrying Value	$ 1,003	$ 939
Weighted Average Useful Life (Years)	17 years	17 years
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 4,325	$ 3,969
Accumulated Amortization	2,144	1,762
Net Carrying Value	$ 2,181	$ 2,207
Weighted Average Useful Life (Years)	4 years 6 months	4 years 4 months 24 days

Goodwill and Other Intangible Assets (Summary of Amortization Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 3,686	$ 4,203	$ 11,675	$ 12,701

Goodwill and Other Intangible Assets (Scheduled Amortization of Intangible Assets for Next Five Years) (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2022	$ 3,593
2023	14,174
2024	13,822
2025	12,070
2026	11,842
2027	11,748
Total	$ 67,249

Income Taxes (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
Income Taxes (Details) - USD ($) $ in Millions	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Effective income tax rate expense (benefit)	9.00%	(33.00%)	17.00%	(318.00%)
Net deferred tax liability	$ 28.0		$ 28.0		$ 26.4
Valuation allowances against deferred tax assets	$ 17.8		$ 17.8		$ 13.3

Leases (Narrative) (Details) - USD ($) $ in Thousands	Jun. 01, 2021	Jan. 06, 2021	Sep. 30, 2022	Dec. 31, 2021
Leases [Abstract]
Increase in the present value of future lease obligations and corresponding right-of-use asset	$ 9,800	$ 23,300	$ 41,320	$ 45,714
Increase in operating lease liability	$ 9,800	$ 23,300
Discount rate	5.46%	6.41%
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]			Other Liabilities, Current	Other Liabilities, Current

Leases (Schedule Of Supplemental Balance Sheet Information Related To Leases) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021	Jun. 01, 2021	Jan. 06, 2021
Operating leases:
Operating lease right-of-use assets	$ 55,405	$ 58,097
Accumulated amortization	(14,085)	(12,383)
Operating lease right-of-use assets, net	41,320	45,714	$ 9,800	$ 23,300
Current maturities of operating leases	3,061	3,149
Non-current maturities of operating leases	40,915	44,869
Total operating lease liabilities	43,976	48,018
Finance leases:
Finance leases, Property and equipment, at cost	5,861	6,759
Finance leases, Accumulated amortization	(2,166)	(2,105)
Finance leases, property and equipment, net	3,695	4,654
Current maturities of finance leases	469	528
Non-current maturities of finance leases	3,450	4,374
Total finance lease liabilities	$ 3,919	$ 4,902
Weighted average remaining lease term (in years): Operating leases	12 years 2 months 12 days	12 years 6 months
Weighted average remaining lease term (in years): Finance leases	8 years 1 month 6 days	8 years 9 months 18 days
Weighted average discount rate: Operating leases	5.90%	5.80%
Weighted average discount rate: Finance leases	2.10%	2.00%

Leases (Summary Of Lease Costs) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Leases [Abstract]
Amortization of property and equipment	$ 127	$ 190	$ 395	$ 500
Interest expense on finance leases	22	27	69	85
Total finance lease expense	149	217	464	585
Operating lease expense	1,853	1,989	5,656	5,566
Sublease income	(92)	(92)	(275)	(308)
Total lease expense	$ 1,910	$ 2,114	$ 5,845	$ 5,843

Leases (Schedule Of Supplemental Cash Flow Information Related To Leases) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Leases [Abstract]
Operating cash flows for operating leases	$ 4,939	$ 4,536
Financing cash flows for finance leases	346	446
Operating cash flows for finance leases	$ 62	$ 82

Leases (Schedule Of Minimum Lease Payments For Finance, Operating, And Sublease Income Leases) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Finance Leases
Remainder of 2022	$ 120
2023	549
2024	545
2025	525
2026	508
Thereafter	2,000
Total minimum lease payments	4,247
Less amount representing interest	(328)
Present value of net minimum lease payments	3,919	$ 4,902
Less current maturities	(469)	(528)
Lease liabilities, less current maturities	3,450	4,374
Operating Leases
Remainder of 2022	660
2023	5,624
2024	6,252
2025	5,173
2026	4,719
Thereafter	40,986
Total minimum lease payments	63,414
Less amount representing interest	(19,438)
Present value of net minimum lease payments	43,976	48,018
Less current maturities	(3,061)	(3,149)
Lease liabilities, less current maturities	40,915	$ 44,869
Sublease Income, Remainder of 2022	31
Sublease Income, 2023	0
Sublease Income, 2024	0
Sublease Income, 2025	0
Sublease Income, 2026	0
Sublease Income, Thereafter	0
Sublease Income	$ 31

Debt (Narrative) (Details)				3 Months Ended		9 Months Ended
Debt (Narrative) (Details)	Jun. 02, 2021 USD ($)	Jun. 01, 2021	Jun. 18, 2020 USD ($) $ / shares	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) day	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)	Dec. 01, 2017 USD ($)
Line of Credit Facility [Line Items]
Secured term loan facility				$ 315,369,000		$ 315,369,000		$ 317,627,000
Debt issuance costs						0	$ 2,219,000
Long-term debt				308,236,000		308,236,000		309,123,000
Interest expense				4,800,000	$ 4,100,000	$ 12,900,000	13,000,000
Interest Expense
Line of Credit Facility [Line Items]
Debt issuance costs	$ 361,000
Debt extinguishment costs	$ 474,000
Credit Agreement
Line of Credit Facility [Line Items]
Revolving credit facility, percentage repaid for no covenants						25.00%
Convertible senior notes
Line of Credit Facility [Line Items]
Interest rate on amounts borrowed			4.25%
Face value			$ 100,000,000
Proceeds from issuance of convertible debt			$ 96,500,000
Conversion ratio			0.0426203
Conversion price (in dollars per share) \| $ / shares			$ 23.46
Debt fair value				$ 92,300,000		$ 92,300,000
Effective interest rate				5.05%		5.05%
Interest expense				$ 1,200,000	$ 1,200,000	$ 3,700,000	$ 3,700,000
Unamortized debt issuance costs				2,000,000		$ 2,000,000
Convertible senior notes \| Circumstance I
Line of Credit Facility [Line Items]
Conversion trading day threshold \| day						20
Conversion consecutive trading day threshold \| day						30
Conversion percentage of stock price threshold						130.00%
Convertible senior notes \| Circumstance II
Line of Credit Facility [Line Items]
Conversion trading day threshold \| day						5
Conversion consecutive trading day threshold \| day						5
Conversion percentage of stock price threshold						98.00%
Convertible senior notes \| Circumstance After July 5, 2023
Line of Credit Facility [Line Items]
Conversion trading day threshold \| day						20
Conversion consecutive trading day threshold \| day						30
Conversion percentage of stock price threshold						130.00%
Conversion percentage of principal amount						100.00%
Secured Debt
Line of Credit Facility [Line Items]
Credit facility aggregate commitments									$ 255,000,000
Term loan balance
Line of Credit Facility [Line Items]
Secured term loan facility				214,313,000		$ 214,313,000		$ 216,000,000	225,000,000
Term loan balance \| Credit Agreement \| Circumstance I
Line of Credit Facility [Line Items]
Debt instrument, extension circumstance period	91 days
Term loan balance \| Credit Agreement \| Circumstance II
Line of Credit Facility [Line Items]
Debt instrument, extension circumstance period	182 days
Term loan balance \| Base Rate
Line of Credit Facility [Line Items]
Credit facility margin		2.25%
Term loan balance \| Base Rate \| Credit Agreement
Line of Credit Facility [Line Items]
Credit facility margin	2.50%
Term loan balance \| LIBOR
Line of Credit Facility [Line Items]
Credit facility margin		3.25%
Term loan balance \| LIBOR \| Credit Agreement
Line of Credit Facility [Line Items]
Credit facility margin	3.50%
Revolving Credit Facility
Line of Credit Facility [Line Items]
Credit facility aggregate commitments									$ 30,000,000
Revolving Credit Facility And Term Loan
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 \| Credit Agreement
Line of Credit Facility [Line Items]
Debt instrument, extension period	2 years 6 months
Revolving Credit Facility And Term Loan \| Convertible senior notes \| Credit Agreement
Line of Credit Facility [Line Items]
Interest rate on amounts borrowed	4.25%
Accounting Standards Update 2020-06 \| Cumulative Effect, Period of Adoption, Adjustment \| Convertible senior notes
Line of Credit Facility [Line Items]
Long-term debt				$ 100,000,000		$ 100,000,000

Debt (Schedule Of Short-Term And Long-Term Balances Of Term Loan) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021	Dec. 01, 2017
Debt Instrument [Line Items]
Total loan balance	$ 315,369	$ 317,627
Less unamortized loan origination costs	(7,133)	(8,504)
Net borrowings	308,236	309,123
Less short-term loan balance	(1,562)	(1,630)
Long-term loan balance	306,674	307,493
2.45% Sparkasse Zollernalb (KFW Loan 1)
Debt Instrument [Line Items]
Total loan balance	$ 325	566
Interest rate on amounts borrowed	2.45%
1.40% Sparkasse Zollernalb (KFW Loan 2)
Debt Instrument [Line Items]
Total loan balance	$ 731	1,061
Interest rate on amounts borrowed	1.40%
Term loan balance
Debt Instrument [Line Items]
Total loan balance	$ 214,313	216,000	$ 225,000
Convertible senior notes
Debt Instrument [Line Items]
Total loan balance	$ 100,000	$ 100,000

Commitments and Contingencies (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Termination and wind-down expenses	$ 4.7	$ 4.7

Revenue Recognition (Disaggregation Of Revenue) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Disaggregation of Revenue [Line Items]
Total sources of revenue	$ 76,838	$ 72,207	$ 234,391	$ 219,442
Domestic hospitals
Disaggregation of Revenue [Line Items]
Total sources of revenue	40,842	36,129	117,343	111,291
International hospitals
Disaggregation of Revenue [Line Items]
Total sources of revenue	24,119	25,458	79,768	79,219
International distributors
Disaggregation of Revenue [Line Items]
Total sources of revenue	11,469	10,544	34,685	28,694
CardioGenesis cardiac laser therapy
Disaggregation of Revenue [Line Items]
Total sources of revenue	$ 408	$ 76	$ 2,595	$ 238

- 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
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 2: 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 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9038-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-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 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130543-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 9: 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 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130545-203045

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-URI http://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

Stock Compensation (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Capitalized stock compensation expense	$ 144	$ 115	$ 465	$ 424
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
ESPP, percentage of market price for eligible employees			85.00%
Employee stock purchase plan (in shares)	58,000	51,000	95,000	87,000
RSAs, RSUs, And PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized awards from approved stock incentive plans (in shares)			520,000	494,000
Aggregate grant date market value			$ 9,700	$ 12,500
Officers
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Grants of stock options (in shares)			314,000	226,000

Stock Compensation (Schedule Of Weighted-Average Assumptions Used To Determine The Fair Value Of Options) (Details)	3 Months Ended	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2022
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected life		5 years
Expected stock price volatility		40.00%
Risk-free interest rate		1.89%
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected life	6 months	6 months
Expected stock price volatility	49.00%	31.00%
Risk-free interest rate	2.52%	0.22%

Stock Compensation (Summary Of Total Stock Compensation Expenses) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock compensation expense	$ 3,233	$ 2,990	$ 9,654	$ 7,895
RSA, RSU, and PSU expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock compensation expense	2,622	2,465	7,860	6,211
Stock option and ESPP expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock compensation expense	$ 611	$ 525	$ 1,794	$ 1,684

(Loss) Earnings Per Common Share (Computation Of Basic And Diluted (Loss) Income Per Common Share) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Basic (loss) income per common share
Net (loss) income	$ (13,713)	$ 10,582	$ (21,361)	$ 5,266
Net loss (income) allocated to participating securities	70	(63)	109	(34)
Net (loss) income allocated to common shareholders	$ (13,643)	$ 10,519	$ (21,252)	$ 5,232
Basic weighted-average common shares outstanding (in shares)	40,115,000	39,086,000	39,999,000	38,924,000
Basic (loss) income per common share (in usd per share)	$ (0.34)	$ 0.27	$ (0.53)	$ 0.13
Diluted (loss) income per common share
Net (loss) income	$ (13,713)	$ 10,582	$ (21,361)	$ 5,266
Net loss (income) allocated to participating securities	70	(55)	109	(34)
Net loss attributable to convertible senior notes	0	919	0	0
Net (loss) income allocated to common shareholders	$ (13,643)	$ 11,446	$ (21,252)	$ 5,232
Effect of dilutive stock options and awards (in shares)	0	505,000	0	572,000
Effect of convertible senior notes (in shares)	0	4,862,000	0	0
Diluted weighted-average common shares outstanding (in shares)	40,115,000	44,453,000	39,999,000	39,496,000
Diluted (loss) income per common share (in usd per share)	$ (0.34)	$ 0.26	$ (0.53)	$ 0.13
Effect of dilutive stock options and awards
Diluted (loss) income per common share
Antidilutive shares (in shares)		539,000		517,000
Effect of convertible senior notes
Diluted (loss) income per common share
Antidilutive shares (in shares)				4,860,685

Segment Information (Narrative) (Details)	9 Months Ended
Segment Information (Narrative) (Details)	Sep. 30, 2022 USD ($) segment
Segment Reporting Information [Line Items]
Number of reportable segments \| segment	2
Intersegment Eliminations
Segment Reporting Information [Line Items]
Intersegment revenues \| $	$ 0

- 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
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-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 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iv))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iv))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(A))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 10: 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 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(i))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(i))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(5))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9038-108599

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iii)(A))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(5))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 18: 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 19: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 235
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-URI http://asc.fasb.org/extlink&oid=120399901&loc=d3e537907-122884

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(B))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 22: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(ii))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(1))
-URI http://asc.fasb.org/extlink&oid=123367319&loc=SL114868664-224227

+ Details

Segment Information (Revenues, Cost Of Products And Services, And Gross Margins For Operating Segments) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Segment Reporting Information [Line Items]
Total revenues	$ 76,838	$ 72,207	$ 234,391	$ 219,442
Total cost of products and preservation services	28,094	24,418	82,756	73,302
Total gross margin	48,744	47,789	151,635	146,140
Medical devices
Segment Reporting Information [Line Items]
Total revenues	55,248	53,107	171,726	162,528
Total cost of products and preservation services	17,743	15,503	53,381	46,592
Total gross margin	37,505	37,604	118,345	115,936
Preservation services
Segment Reporting Information [Line Items]
Total revenues	21,590	19,100	62,665	56,914
Total cost of products and preservation services	10,351	8,915	29,375	26,710
Total gross margin	$ 11,239	$ 10,185	$ 33,290	$ 30,204

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-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 30
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 3: 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 4: 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 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iv))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(A))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(B))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(ii))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(i))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(i))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iii)(A))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(5))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iv))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(5))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 18: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03.1,2)
-URI http://asc.fasb.org/extlink&oid=123367319&loc=SL114868664-224227

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Segment Information (Summary Of Net Revenues By Product And Service) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Product Information [Line Items]
Total revenues	$ 76,838	$ 72,207	$ 234,391	$ 219,442
Products
Product Information [Line Items]
Total revenues	55,248	53,107	171,726	162,528
Aortic stent grafts
Product Information [Line Items]
Total revenues	19,674	20,896	69,013	62,165
Surgical sealants
Product Information [Line Items]
Total revenues	17,374	16,544	49,022	52,236
On-X
Product Information [Line Items]
Total revenues	16,456	14,022	47,082	41,843
Other
Product Information [Line Items]
Total revenues	1,744	1,645	6,609	6,284
Preservation services
Product Information [Line Items]
Total revenues	$ 21,590	$ 19,100	$ 62,665	$ 56,914

- Definition

+ References

+ Details

Label	Element	Value
Accounting Standards Update [Extensible Enumeration]	us-gaap_AccountingStandardsUpdateExtensibleList	Accounting Standards Update 2020-06 [Member]

- Definition

Indicates amendment to accounting standards.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL121967933-165497

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL121967933-165497

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (f)(2)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (e)(2)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (f)(1)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (h)(2)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 7
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL122642865-165497

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=124431687&loc=d3e22499-107794

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 65
-Paragraph 8
-Subparagraph (d)(3)
-URI http://asc.fasb.org/extlink&oid=123459177&loc=SL121830611-158277

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (c)(2)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL121967933-165497

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(4)
-URI http://asc.fasb.org/extlink&oid=124431687&loc=d3e22499-107794

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (c)(1)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL121967933-165497

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(3)
-URI http://asc.fasb.org/extlink&oid=124431687&loc=d3e22499-107794

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 5
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL120254526-165497

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (b)(1)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(iv)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 105
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=124434974&loc=SL124442142-165695

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(iii)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 24: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 105
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=124434974&loc=SL124442142-165695

Reference 25: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 26: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (h)(1)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 27: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (c)(2)
-URI http://asc.fasb.org/extlink&oid=124431687&loc=d3e22499-107794

Reference 28: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=122640432&loc=SL121648383-210437

Reference 29: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (a)(2)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 30: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 65
-Paragraph 8
-Subparagraph (d)(2)
-URI http://asc.fasb.org/extlink&oid=123459177&loc=SL121830611-158277

Reference 31: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=122640432&loc=SL121648383-210437

Reference 32: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (a)(3)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 33: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(ii)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 34: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 105
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=124434974&loc=SL124442142-165695

Reference 35: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (f)(2)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 36: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 848
-SubTopic 10
-Section 65
-Paragraph 1
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=122150657&loc=SL122150809-237846

Reference 37: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(1)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 38: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 7
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL122642865-165497

Reference 39: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S65
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=124359872&loc=SL124427846-239511

Reference 40: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 310
-SubTopic 20
-Section 65
-Paragraph 2
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=124402435&loc=SL124402458-218513

Reference 41: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 310
-SubTopic 20
-Section 65
-Paragraph 2
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=124402435&loc=SL124402458-218513

Reference 42: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 65
-Paragraph 5
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123597120&loc=SL120254526-165497

Reference 43: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (a)(1)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 44: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=122640432&loc=SL121648383-210437

Reference 45: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(i)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 46: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 105
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=124434974&loc=SL124442142-165695

Reference 47: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=122640432&loc=SL121648383-210437

Reference 48: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 49: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 105
-SubTopic 10
-Section 65
-Paragraph 6
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=124434974&loc=SL124442142-165695

Reference 50: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (e)(3)
-URI http://asc.fasb.org/extlink&oid=122640432&loc=SL121648383-210437

Reference 51: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 52: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 53: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 54: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 55: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (e)(4)
-URI http://asc.fasb.org/extlink&oid=122640432&loc=SL121648383-210437

Reference 56: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (g)(2)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 57: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (e)(3)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 58: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (f)(1)
-URI http://asc.fasb.org/extlink&oid=124501264&loc=SL117420844-207641

Reference 59: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (e)(4)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 60: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123482062&loc=SL123482106-238011

Reference 61: http://www.xbrl.org/2003/role/disclosureRef
-Topic 848
-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Publisher FASB
-Subparagraph (a)

Reference 62: http://www.xbrl.org/2003/role/disclosureRef
-Topic 848
-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Publisher FASB
-Subparagraph (a)(1)

Reference 63: http://www.xbrl.org/2003/role/disclosureRef
-Topic 848
-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Publisher FASB
-Subparagraph (a)(2)

Reference 64: http://www.xbrl.org/2003/role/disclosureRef
-Topic 848
-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Publisher FASB
-Subparagraph (a)(3)(iii)(01)

Reference 65: http://www.xbrl.org/2003/role/disclosureRef
-Topic 848
-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Publisher FASB
-Subparagraph (a)(3)(iii)(03)

+ Details