LivaNova (LIVN) 10-Q 1 Nov 18 2018 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Oct. 25, 2018
Document and Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Entity Registrant Name	LIVANOVA PLC
Entity Central Index Key	1,639,691
Current Fiscal Year End Date	--12-31
Entity Emerging Growth Company	false
Entity Small Business	false
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		48,685,079
Trading Symbol	LIVN

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Income Statement [Abstract]
Net sales	$ 272,082	$ 251,253	$ 809,978	$ 733,921
Cost of sales	94,300	87,752	270,891	251,743
Product remediation	3,434	1,642	8,691	2,573
Gross profit	174,348	161,859	530,396	479,605
Operating expenses:
Selling, general and administrative	115,136	97,201	342,736	278,805
Research and development	42,417	22,903	108,384	77,122
Merger and integration expenses	12,659	2,010	20,028	7,708
Restructuring expenses	436	1,183	2,793	13,810
Amortization of intangibles	9,457	8,540	28,075	24,616
Total operating expenses	180,105	131,837	502,016	402,061
Operating (loss) income from continuing operations	(5,757)	30,022	28,380	77,544
Interest income	184	199	863	724
Interest expense	(2,633)	(1,421)	(7,750)	(5,314)
Gain on acquisitions	0	0	11,484	39,428
Foreign exchange and other (losses) gains	(727)	527	(1,070)	863
(Loss) income from continuing operations before tax	(8,933)	29,327	31,907	113,245
Income tax (benefit) expense	(2,660)	1,905	203	10,819
Losses from equity method investments	0	(407)	(627)	(16,505)
Net (loss) income from continuing operations	(6,273)	27,015	31,077	85,921
Net (loss) income from discontinued operations	(904)	815	(9,915)	678
Net (loss) income	$ (7,177)	$ 27,830	$ 21,162	$ 86,599
Basic (loss) income per share - continuing operation (in Dollars per Share)	$ (0.13)	$ 0.56	$ 0.64	$ 1.79
Basic (loss) income per share - discontinued operation (in Dollars per Share)	(0.02)	0.02	(0.20)	0.01
Basic (loss) income per share (in Dollars per Share)	(0.15)	0.58	0.44	1.80
Diluted (loss) income per share - continuing operation (in Dollars per Share)	(0.13)	0.56	0.63	1.78
Diluted (loss) income per share - discontinued operation (in Dollars per Share)	(0.02)	0.01	(0.20)	0.01
Diluted (loss) income per share (in Dollars per Share)	$ (0.15)	$ 0.57	$ 0.43	$ 1.79
Shares used in computing basic (loss) income per share (in Shares)	48,637	48,181	48,484	48,130
Shares used in computing diluted (loss) income per share (in Shares)	48,637	48,534	49,427	48,339

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (7,177)	$ 27,830	$ 21,162	$ 86,599
Other comprehensive income (loss):
Net change in unrealized gains (losses) on derivatives	693	(1,980)	237	(5,923)
Tax effect	(168)	473	(57)	1,756
Net of tax	525	(1,507)	180	(4,167)
Foreign currency translation adjustment, net of tax	1,863	39,106	(45,738)	111,123
Total other comprehensive income (loss)	2,388	37,599	(45,558)	106,956
Total comprehensive (loss) income	$ (4,789)	$ 65,429	$ (24,396)	$ 193,555

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Current Assets:
Cash and cash equivalents	$ 79,948	$ 93,615
Accounts receivable, net of allowance of $9,464 at September 30, 2018 and $9,418 at December 31, 2017	252,304	282,145
Inventories	153,056	144,470
Prepaid and refundable taxes	50,264	46,274
Assets held for sale	0	13,628
Assets of discontinued operations	0	250,689
Prepaid expenses and other current assets	37,666	39,037
Total Current Assets	573,238	869,858
Property, plant and equipment, net	188,460	192,359
Goodwill	969,277	784,242
Intangible assets, net	784,264	535,397
Investments	24,113	34,492
Deferred tax assets, net	65,808	11,559
Other assets	5,520	75,984
Total Assets	2,610,680	2,503,891
Current Liabilities:
Current debt obligations	48,983	84,034
Accounts payable	88,883	85,915
Accrued liabilities and other	118,733	78,942
Taxes payable	18,883	12,826
Accrued employee compensation and related benefits	71,585	66,224
Liabilities of discontinued operations	0	78,075
Total Current Liabilities	347,067	406,016
Long-term debt obligations	108,090	61,958
Contingent consideration	164,610	33,973
Deferred income taxes liability	150,142	123,342
Long-term employee compensation and related benefits	30,315	28,177
Other long-term liabilities	25,464	35,111
Total liabilities	825,688	688,577
Commitments and contingencies (Note 11)
Stockholders’ Equity:
Ordinary Shares, £1.00 par value: unlimited shares authorized; 48,693,535 shares issued and 48,680,054 shares outstanding at September 30, 2018; 48,290,276 shares issued and 48,287,346 shares outstanding at December 31, 2017	75,311	74,750
Additional paid-in capital	1,750,886	1,735,048
Accumulated other comprehensive (loss) income	(245)	45,313
Accumulated deficit	(40,932)	(39,664)
Treasury stock at cost, 13,481 shares at September 30, 2018 and 2,930 shares at December 31, 2017	(28)	(133)
Total Stockholders’ Equity	1,784,992	1,815,314
Total Liabilities and Stockholders’ Equity	$ 2,610,680	$ 2,503,891

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) $ in Thousands	Sep. 30, 2018USD ($)shares	Sep. 30, 2018£ / shares	Dec. 31, 2017USD ($)shares	Dec. 31, 2017£ / shares
Statement of Financial Position [Abstract]
Allowance for doubtful accounts | $	$ 9,464		$ 9,418
Ordinary shares, par value (in Pounds per Share) | £ / shares		£ 1		£ 1
Ordinary shares issued (shares)	48,693,535		48,290,276
Ordinary shares outstanding (shares)	48,680,054		48,287,346
Treasury stock (shares)	13,481		2,930

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Operating Activities:
Net (loss) income	$ 21,162	$ 86,599
Non-cash items included in net income:
Depreciation	24,979	27,880
Amortization	28,052	35,445
Stock-based compensation	21,387	14,252
Deferred income tax benefit	(13,488)	(27,270)
Losses from equity method investments	1,838	20,072
Gain on acquisitions	(11,484)	(39,428)
Impairment of property, plant and equipment	517	4,581
Amortization of income taxes payable on inter-company transfers of property	4,155	23,831
Other	(1,902)	3,373
Changes in operating assets and liabilities:
Accounts receivable, net	30,506	(19,107)
Inventories	(7,622)	(11,006)
Other current and non-current assets	(16,757)	(17,846)
Accounts payable and accrued current and non-current liabilities	17,888	(14,958)
Restructuring reserve	368	(12,753)
Net cash provided by operating activities	99,599	73,665
Investing Activities:
Acquisitions, net of cash acquired	(279,863)	(14,194)
Purchases of property, plant and equipment and other	(25,099)	(24,004)
Proceeds from the sale of CRM business franchise	186,682	0
Proceeds from asset sales	13,872	5,346
Proceeds from sale of investment	0	3,192
Loans to investees	0	(6,928)
Purchases of investments	(3,000)	(5,209)
Net cash used in investing activities	(107,408)	(41,797)
Financing Activities:
Change in short-term borrowing, net	(31,281)	(18,054)
Proceeds from short-term borrowing (maturities greater than 90 days)	240,000	20,000
Repayment of short-term borrowing (maturities greater than 90 days)	(240,000)	0
Proceeds from long-term debt obligations	60,000	0
Repayment of long-term debt obligations	(12,290)	(11,615)
Proceeds from exercise of stock options	4,177	3,221
Payment of deferred consideration - acquisition of Caisson Interventional, LLC	(14,073)	0
Shares repurchased from employees for minimum tax withholding	(8,559)	(2,391)
Other	(884)	(1,161)
Net cash used in financing activities	(2,910)	(10,000)
Effect of exchange rate changes on cash and cash equivalents	(2,948)	3,501
Net (decrease) increase in cash and cash equivalents	(13,667)	25,369
Cash and cash equivalents at beginning of period	93,615	39,789
Cash and cash equivalents at end of period	$ 79,948	$ 65,158

Unaudited Condensed Consolidate

Unaudited Condensed Consolidated Financial Statements	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Unaudited Condensed Consolidated Financial Statements	Note 1. Unaudited Condensed Consolidated Financial Statements Basis of Presentation The accompanying condensed consolidated financial statements of LivaNova as of, and for the three and nine months ended September 30, 2018 and September 30, 2017 , have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2017 has been derived from audited financial statements contained in our 2017 Form 10-K, but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments (consisting of only normal recurring adjustments) considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries, for the three and nine months ended September 30, 2018 and are not necessarily indicative of the results that may be expected for the year ending December 31, 2018 . The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying our 2017 Form 10-K. Sale of our Cardiac Rhythm Management Business Franchise We completed the sale of our Cardiac Rhythm Management (“CRM”) business franchise to MicroPort Cardiac Rhythm B.V. and MicroPort Scientific Corporation (the “CRM Sale”) on April 30, 2018 for total cash proceeds of $195.9 million , less cash transferred of $9.2 million , subject to a closing working capital adjustment. In conjunction with the CRM Sale, we entered into transition services agreements to provide certain support services for generally up to twelve months from the closing date of the sale. We previously concluded that the sale of CRM represents a strategic shift in our business that will have a major effect on future operations and financial results. Accordingly, the operating results of CRM are classified as discontinued operations in our condensed consolidated statements of income. The assets and liabilities of CRM are presented as assets or liabilities of discontinued operations in the condensed consolidated balance sheet at December 31, 2017 . Reclassification of Prior-Period Comparative Presentation We have reclassified certain prior period amounts for comparative purposes. These reclassifications did not have a material effect on our financial condition, results of operations or cash flows. We reclassified $34.0 million to contingent consideration from other long-term liabilities at December 31, 2017 to conform to the presentation on the condensed consolidated balance sheet at September 30, 2018 . We have reclassified certain amounts reported in “Note 4. Discontinued Operations” for the nine months ended September 30, 2018. These corrections had no net impact to our previously reported net loss from discontinued operations for the three and six months ended June 30, 2018. Significant Accounting Policies Our significant accounting policies are detailed in "Note 2: Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies" of our 2017 Form 10-K. On January 1, 2018, we adopted ASC Update (“ASU”) No 2014-09, Revenue from Contracts with Customers. Refer to “ Note 2. Revenue Recognition .” We elected the cumulative effect transition method; however, we recognized no cumulative effect to the opening balance of retained earnings because the impact on the timing of when revenue is recognized within our Cardiovascular segment (formerly Cardiac Surgery), specifically related to heart-lung machines and preventative maintenance contracts on cardiopulmonary equipment, was insignificant. The timing of revenue recognition for products and related revenue streams within our Neuromodulation segment and discontinued operations did not change.

Revenue Recognition

Revenue Recognition	9 Months Ended
	Sep. 30, 2018
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Note 2. Revenue Recognition We generate our revenue through contracts with customers that primarily consist of hospitals, healthcare institutions, distributors and other organizations. Revenue is measured based on consideration specified in a contract with a customer, and excludes amounts collected on behalf of third parties. We measure the consideration based upon the estimated amount to be received. The amount of consideration we ultimately receive varies depending upon the return terms, sales rebates, discounts, and other incentives that we may offer, which are accounted for as variable consideration when estimating the amount of revenue to recognize. The estimate of variable consideration requires significant judgment. We have historically experienced a low rate of product returns and the total dollar value of product returns has not been significant to our financial statements. We recognize revenue when a performance obligation is satisfied by transferring the control of a product or providing service to a customer. Some of our contracts include the purchase of multiple products and/or services. In such cases, we allocate the transaction price based upon the relative estimated stand-alone price of each product and/or service sold. We record state and local sales taxes net; that is, we exclude sales tax from revenue. Typically, our contracts do not have a significant financing component. We incur incremental commission fees paid to the sales force associated with the sale of products. We apply the practical expedient within ASC 606-10-50-22 and have elected to recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset the entity would otherwise recognize is one year or less. As a result, no commissions are capitalized as contract costs at September 30, 2018 . The following is a description of the principal activities (separated by reportable segments) from which we generate our revenue. For more detailed information about our reportable segments including disaggregated revenue results by major product line and primary geographic markets, see “ Note 16. Geographic and Segment Information .” Cardiovascular Products and Services The Cardiovascular (“CV”) segment has three primary product lines: cardiopulmonary products, heart valves and advanced circulatory support. Cardiopulmonary products include oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Heart valves include mechanical heart valves, tissue heart valves and related repair products. Advanced circulatory support, which represents our recently acquired TandemLife business, includes temporary life support product kits that can include a combination of pumps, oxygenators, and cannulae. Cardiopulmonary products may include performance obligations associated with assembly and installation of equipment. Accordingly, we allocate a portion of the sales prices to installation obligations and recognize that revenue when the service is provided. We recognize revenue for equipment and accessory product sales when control of the equipment or product passes to the customer. Heart valve revenue is recognized when control passes to the customer, usually at the point of surgery. Advanced circulatory support revenue is recognized when control passes to the customer, usually at the point of shipment. Technical services include installation, repair and maintenance of cardiopulmonary equipment under service contracts or upon customer request. Technical service agreements generally provide for upfront payments in advance of rendering services or periodic billing over the contract term. Amounts billed in advance are deferred and recognized as revenue when the performance obligation is satisfied. Technical services are not a significant component of CV revenue and have been presented with the related equipment and accessories revenue. Neuromodulation Products The Neuromodulation (“NM”) segment generates its revenue from the sale of neuromodulation therapy systems for the treatment of drug-resistant epilepsy, treatment-resistant depression and obstructive sleep apnea. The NM product line includes the VNS Therapy System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. The NM product line also includes an implantable device for the treatment of obstructive sleep apnea that stimulates multiple tongue muscles via the hypoglossal nerve, which opens the airway while a patient is sleeping. We recognize revenue for NM product sales when control passes to the customer. Contract Balances Due to the nature of our products and services, revenue producing activities may result in contract assets and contract liabilities which are insignificant to our financial position and results of operations. These activities relate primarily to CV technical services contracts for short-term and multi-year service agreements. Contract assets are primarily comprised of unbilled revenues, which occur when a performance obligation has been completed, but not billed to the customer. Contract liabilities are made up of deferred revenue, which occurs when a customer pays for a service, before a performance obligation has been completed. Contract assets are included within “Prepaid expenses and other current assets” in the condensed consolidated balance sheets and were insignificant at September 30, 2018 and December 31, 2017 . As of September 30, 2018 and December 31, 2017 , contract liabilities of $5.2 million and $3.8 million , respectively, are included within “Accrued liabilities and other” and “Other long-term liabilities” in the condensed consolidated balance sheets.

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2018
Business Combinations [Abstract]
Business Combinations	Note 3. Business Combinations Caisson Interventional, LLC On May 2, 2017, we acquired the remaining 51% equity interests in Caisson Interventional, LLC ( “ Caisson”) for a purchase price of up to $72.0 million , net of $6.3 million of debt forgiveness, consisting of $18.0 million paid at closing, $14.4 million paid during the second quarter of 2018, and contingent consideration of up to $39.6 million to be paid on a schedule driven primarily by regulatory approvals and a sales-based earnout. Caisson is focused on the design, development and clinical evaluation of a novel transcatheter mitral valve replacement (“TMVR”) implant device with a fully transvenous delivery system for the treatment of mitral valve regurgitation. The purchase price allocation was finalized during the second quarter of 2018 and there were no adjustments to the preliminary purchase price allocation during the measurement period. We performed a quantitative impairment assessment, as of April 1, 2018, for the goodwill and in-process research and development assets arising from the Caisson acquisition. Based upon the assessment performed, we determined that the goodwill and the in-process research and development assets were not impaired. The quantitative impairment assessment was performed using management’s current estimate of future cash flows which are based on the expected timing of future regulatory approvals. A delay in the anticipated timing of these regulatory approvals or a change in management’s estimates could result in a fair value of the in-process research and development that is below its carrying amount. We will continue to monitor any changes in circumstances for indicators of impairment. ImThera Medical, Inc. On January 16, 2018, we acquired the remaining 86% outstanding interest in ImThera Medical, Inc. (“ImThera”) for cash consideration of up to $225 million . Cash in the amount of $78.3 million was paid at closing with the balance to be paid based on achievement of a certain regulatory milestone and a sales-based earnout. ImThera manufactures an implantable device for the treatment of obstructive sleep apnea that stimulates multiple tongue muscles via the hypoglossal nerve, which opens the airway while a patient is sleeping. ImThera has a commercial presence in the European market, and an FDA pivotal study is ongoing in the U.S. The following table presents the acquisition date fair value of the consideration transferred and the fair value of our interest in ImThera prior to the acquisition (in thousands): Cash $ 78,332 Contingent consideration 112,744 Fair value of our interest in ImThera prior to the acquisition (1) 25,580 Fair value of consideration transferred $ 216,656 (1) The fair value of our previously-held interest in ImThera was determined based on the fair value of total consideration transferred and application of a discount for lack of control. As a result, we recognized a gain of $11.5 million for the fair value in excess of our carrying value of $14.1 million . The gain is reflected as “Gain on acquisitions” on our condensed consolidated statement of income for the nine months ended September 30, 2018 . The following table presents the purchase price allocation at fair value for the ImThera acquisition including certain measurement period adjustments (in thousands): Initial Purchase Price Allocation Measurement Period Adjustments (1) Adjusted Purchase Price Allocation In-process research and development (2) $ 151,605 $ 10,677 $ 162,282 Developed technology 5,661 (5,661 ) — Goodwill 87,063 (4,467 ) 82,596 Deferred income tax liabilities, net (3) (27,980 ) (1,278 ) (29,258 ) Other assets and liabilities, net 836 200 1,036 Net assets acquired $ 217,185 $ (529 ) $ 216,656 (1) During the second quarter of 2018, measurement period adjustments were recorded based upon new information obtained about facts and circumstances that existed as of the acquisition date. (2) The fair value of in-process research and development ("IPR&D") was determined using the income approach, which is a valuation technique that provides a fair value estimate based on the market participant expectations of cash flows the asset would generate. The cash flows were discounted commensurate with the level of risk associated with the asset. The discount rates were developed after assigning a probability of success to achieving the projected cash flows based on the current stage of development, inherent uncertainty in reaching certain regulatory milestones and risks associated with commercialization of the product. The IPR&D amount is included in “Intangible assets, net” in the condensed consolidated balance sheet at September 30, 2018 . (3) The amounts are presented net of deferred tax assets acquired. Goodwill arising from the ImThera acquisition, which is not deductible for tax purposes, primarily represents the synergies anticipated between ImThera and our existing neuromodulation business. The assets acquired, including goodwill, are recognized in our Neuromodulation segment. During the second quarter of 2018, we determined that developments in the ImThera clinical trial will result in a minimum 12-month delay of regulatory approval. This delay constituted a triggering event that required evaluation of the in-process research and development asset for impairment. Based on the quantitative impairment evaluation, the in-process research and development asset was not impaired; however, a further delay or a change in management’s estimates could result in a fair value that is below the carrying amount for such an asset. We will continue to monitor any changes in circumstances for indicators of impairment. The results of the ImThera acquisition added $0.1 million and $0.3 million in revenue and $2.9 million and $6.5 million in operating losses during the three and nine months ended September 30, 2018 , respectively. Additionally, we recognized ImThera acquisition-related expenses of approximately $0.1 million and $0.4 million for legal and valuation expenses during the three and nine months ended September 30, 2018 , respectively. These expenses are included within “Selling, general and administrative” expenses in the condensed consolidated statements of income. Pro forma financial information assuming the ImThera acquisition had occurred as of the beginning of the calendar year prior to the year of acquisition was not material for disclosure purposes. The ImThera business combination involved contingent consideration arrangements composed of potential cash payments upon the achievement of a certain regulatory milestone and a sales-based earnout associated with sales of products covered by the purchase agreement. The sales-based earnout was valued using projected sales from our internal strategic plan. Both arrangements are Level 3 fair value measurements and include the following significant unobservable inputs (in thousands): ImThera Acquisition Fair value at January 16, 2018 Valuation Technique Unobservable Input Ranges Regulatory milestone-based payment $ 50,429 Discounted cash flow Discount rate 4.3% - 4.7% Probability of payment 85% - 95% Projected payment years 2020 - 2021 Sales-based earnout 62,315 Monte Carlo simulation Risk-adjusted discount rate 11.5% Credit risk discount rate 4.7% - 5.8% Revenue volatility 29.3% Probability of payment 85% - 95% Projected years of earnout 2020 - 2025 $ 112,744 TandemLife On April 4, 2018, we acquired CardiacAssist, Inc., doing business as TandemLife (“TandemLife”) for cash consideration of up to $254 million . Cash of $204 million was paid at closing with up to $50 million in contingent consideration based on achieving regulatory milestones. TandemLife, headquartered in Pittsburgh, Pennsylvania, is focused on the delivery of leading-edge temporary life support systems, including cardiopulmonary and respiratory support solutions. TandemLife complements our Cardiovascular portfolio, and expands our existing line of cardiopulmonary products. The following table presents the acquisition date fair value of the consideration transferred (in thousands): Cash $ 203,671 Contingent consideration 40,190 Fair value of consideration transferred $ 243,861 The following table presents the preliminary purchase price allocation at fair value for the TandemLife acquisition (in thousands): Initial Purchase Price Allocation Measurement Period Adjustments (1) Adjusted Purchase Price Allocation In-process research and development (2) (3) $ 110,977 $ (3,474 ) $ 107,503 Trade names (2) 11,539 11,539 Developed technology (2) 6,387 6,387 Goodwill 118,917 2,771 121,688 Inventory 10,296 (140 ) 10,156 Other assets and liabilities, net 3,632 3,632 Deferred income tax liabilities, net (4) (17,887 ) 843 (17,044 ) Net assets acquired $ 243,861 $ — $ 243,861 (1) During the third quarter of 2018, measurement period adjustments were recorded based upon new information regarding future estimates of R&D expenses that existed as of the acquisition date. (2) The amounts are included in “Intangible assets, net” in the condensed consolidated balance sheet at September 30, 2018 . Trade names and developed technology are amortized over remaining useful lives of 15 and 2 years, respectively. (3) The fair value of in-process research and development ("IPR&D") was determined using the income approach, which is a valuation technique that provides a fair value estimate based on the market participant expectations of cash flows the asset would generate. The cash flows were discounted commensurate with the level of risk associated with the asset. The discount rates were developed after assigning a probability of success to achieving the projected cash flows based on the current stage of development, inherent uncertainty in reaching certain regulatory milestones and risks associated with commercialization of the product. (4) The amounts include a provisional estimate for deferred tax assets acquired. Goodwill arising from the TandemLife acquisition, which is not deductible for tax purposes, primarily represents the synergies anticipated between TandemLife and our existing cardiovascular business. The assets acquired, including goodwill, are recognized in our Cardiovascular segment. The results of the TandemLife acquisition added $6.1 million and $12.1 million in revenue and $6.0 million and $12.1 million in operating losses during the three and nine months ended September 30, 2018 , respectively. Additionally, we recognized TandemLife acquisition-related expenses of approximately $0.4 million and $2.2 million for legal and valuation expenses during the three and nine months ended September 30, 2018 , respectively. These expenses are included within “Selling, general and administrative” expenses in the condensed consolidated statements of income. Pro forma financial information assuming the TandemLife acquisition had occurred as of the beginning of the calendar year prior to the year of acquisition was not material for disclosure purposes. The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs (in thousands): TandemLife Acquisition Fair value at April 4, 2018 Valuation Technique Unobservable Input Ranges Regulatory milestone-based payments $ 40,190 Discounted cash flow Discount rate 4.2% - 4.8% Probability of payments 75% - 95% Projected payment years 2019 - 2020

Discontinued Operations

Discontinued Operations	9 Months Ended
	Sep. 30, 2018
Discontinued Operations and Disposal Groups [Abstract]
Discontinued Operations	Note 4. Discontinued Operations In November 2017, we concluded that the sale of CRM represented a strategic shift in our business that would have a major effect on future operations and financial results. Accordingly, the operating results of CRM are classified as discontinued operations in our condensed consolidated statements of income for all the periods presented in this Quarterly Report on Form 10-Q. The assets and liabilities of CRM are presented as assets or liabilities of discontinued operations in the condensed consolidated balance sheets at December 31, 2017 . We completed the CRM Sale on April 30, 2018 for total cash proceeds of $195.9 million , less cash transferred of $9.2 million , subject to a closing working capital adjustment. In conjunction with the sale, we entered into transition services agreements to provide certain support services for generally up to twelve months from the closing date of the sale. The services include, among others, accounting, information technology, human resources, quality assurance, regulatory affairs, supply chain, clinical affairs and customer support. During the three and nine months ended September 30, 2018 , we recognized income of $1.1 million and $2.0 million , respectively, for providing these services. Income recognized related to the transition services agreements is recorded as a reduction to the related expenses in the associated expense line items in the condensed consolidated statements of income. The following table represents assets and liabilities of CRM presented as assets and liabilities of discontinued operations in the condensed consolidated balance sheet: December 31, 2017 Accounts receivable, net $ 64,684 Inventories 54,097 Prepaid taxes 14,725 Prepaid and other assets 3,498 Property, plant and equipment, net 12,104 Deferred tax assets, net 2,517 Investments 6,098 Intangible assets, net 92,966 Assets of discontinued operations $ 250,689 Accounts payable 26,501 Accrued liabilities and other 7,669 Taxes payable 5,084 Accrued employee compensation and benefits 30,753 Deferred income taxes liability 8,068 Liabilities of discontinued operations $ 78,075 The following table represents the financial results of CRM presented as net (loss) income from discontinued operations in the condensed consolidated statements of income: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 (1) 2017 Revenues $ — $ 58,411 $ 77,366 $ 182,235 Cost of sales — 20,493 27,306 66,778 Gross profit — 37,918 50,060 115,457 Selling, general and administrative expenses 543 24,000 43,441 74,997 Research and development — 8,502 16,577 26,879 Merger and integration expenses — 3 — 35 Restructuring expenses — (391 ) 651 (1,750 ) Amortization of intangibles — 3,810 — 10,829 Revaluation gain on assets and liabilities held for sale — — (1,213 ) — Loss on sale of CRM — — 214 — Total operating expenses 543 35,924 59,670 110,990 Operating (loss) income from discontinued operations (543 ) 1,994 (9,610 ) 4,467 Foreign exchange and other gains (losses) — 12 102 (160 ) (Loss) income from discontinued operations, before tax (543 ) 2,006 (9,508 ) 4,307 Income tax expense (benefit) 361 8 (804 ) 62 Losses from equity method investments — (1,183 ) (1,211 ) (3,567 ) Net (loss) income from discontinued operations $ (904 ) $ 815 $ (9,915 ) $ 678 (1) CRM financial results for the nine months ended September 30, 2018 include operating activities through the close of the sale on April 30, 2018. Cash flows attributable to our discontinued operations are included in our condensed consolidated statements of cash flows. For the nine months ended September 30, 2018 and 2017, CRM capital expenditures were $0.9 million and $4.3 million , respectively and stock-based compensation expense was $2.1 million and $0.6 million , respectively. For the nine months ended September 30, 2017 CRM depreciation and amortization was $15.4 million .

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2018
Restructuring and Related Activities [Abstract]
Restructuring	Note 5. Restructuring Our 2015 and 2016 Reorganization Plans (the “Plans”) were initiated October 2015 and March 2016, respectively, in conjunction with the completion of the merger of Cyberonics, Inc. and Sorin S.p.A. in October 2015. We initiated these plans to leverage economies of scale, streamline distribution and logistics and strengthen operational and administrative effectiveness in order to reduce overall costs. Costs associated with these plans are reported as ‘Restructuring expenses’ in our operating results in the condensed consolidated statements of income. In March 2017, we committed to a plan to sell our Suzhou Industrial Park facility in Shanghai, China. As a result of this exit plan, we recorded an impairment of the building and equipment of $4.6 million and accrued $0.5 million of additional costs, primarily related to employee severance, during the nine months ended September 30, 2017 . The land, building and equipment were recorded as Assets held for sale on the condensed consolidated balance sheet as of December 31, 2017. We completed the sale of the Suzhou facility in April 2018 and received cash proceeds from the sale of $13.3 million . The following table presents restructuring expense by reportable segment (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Cardiovascular (1) $ 354 $ 441 $ 2,093 $ 6,944 Neuromodulation 17 (32 ) 34 407 Other 65 774 666 6,459 Restructuring expense from continuing operations $ 436 $ 1,183 $ 2,793 $ 13,810 (1) Cardiovascular restructuring expense for the nine months ended September 30, 2017 included building and equipment impairment and additional costs of $5.1 million related to the Suzhou, China facility exit plan.

Product Remediation Liability

Product Remediation Liability	9 Months Ended
	Sep. 30, 2018
Environmental Remediation Obligations [Abstract]
Product Remediation Liability	Note 6. Product Remediation Liability On December 29, 2015, we received an FDA Warning Letter (the “Warning Letter”) alleging certain violations of FDA regulations applicable to medical device manufacturing at our Munich, Germany and Arvada, Colorado facilities. On October 13, 2016, the Centers for Disease Control and Prevention (“CDC”) and FDA separately released safety notifications regarding 3T Heater-Cooler devices in response to which we issued a Field Safety Notice Update for U.S. users of our 3T Heater-Cooler devices to proactively and voluntarily contact facilities to facilitate implementation of the CDC and FDA recommendations. At December 31, 2016, we recognized a liability for a product remediation plan related to our 3T Heater-Cooler device (“3T device”). The remediation plan we developed consists primarily of a modification of the 3T device design to include internal sealing and the addition of a vacuum system to new and existing devices. These changes are intended to address regulatory actions and to reduce further the risk of possible dispersion of aerosols from 3T devices in the operating room. We concluded that it was probable that a liability had been incurred upon management’s approval of the plan and the commitments made by management to various regulatory authorities globally in November and December 2016, and furthermore, the cost associated with the plan was reasonably estimable. The deployment of this solution for commercially distributed devices has been dependent upon final validation and verification of the design changes and approval or clearance by regulatory authorities worldwide, including FDA clearance in the U.S. It is reasonably possible that our estimate of the remediation liability could materially change in future periods due to the various significant assumptions involved such as customer behavior, market reaction and the timing of approvals or clearance by regulatory authorities worldwide. In April 2017, we obtained CE Mark in Europe for the design change of the 3T device, and in May 2017 we completed our first vacuum canister and internal sealing upgrade on a customer-owned device. We are currently implementing the vacuum canister and internal sealing upgrade program in as many countries as possible until all devices are upgraded. On October 11, 2018, after review of information provided by LivaNova, the FDA concluded that LivaNova could commence the vacuum canister and internal sealing upgrade program in the U.S. As part of the remediation plan, we continue to offer a no-charge deep disinfection service (deep cleaning service) for 3T device users as we receive the required regulatory approvals. On April 12, 2018, the FDA agreed to allow us to move forward with the deep cleaning service in the U.S., adding to the growing list of countries around the world in which we offer this service. Finally, we are continuing to offer the loaner program for 3T devices, initiated in the fourth quarter of 2016, to provide existing 3T device users with a new loaner 3T device at no charge pending regulatory approval and implementation of the vacuum system addition and deep disinfection service worldwide. This loaner program began in the U.S. and is being made available progressively on a global basis, prioritizing and allocating devices to 3T device users based on pre-established criteria. Changes in the carrying amount of the product remediation liability are as follows (in thousands): Balance at December 31, 2017 $ 27,546 Remediation activity (9,442 ) Effect of changes in foreign currency exchange rates (157 ) Balance at September 30, 2018 (1) $ 17,947 (1) At September 30, 2018 , the product remediation liability balance is included within ‘Accrued liabilities and other’ and ‘Other long-term liabilities’ in the condensed consolidated balance sheet. We recognized product remediation expenses during the three and nine months ended September 30, 2018 , of $3.4 million and $8.7 million , respectively, and $1.6 million and $2.6 million during the three and nine months ended September 30, 2017 , respectively. Product remediation expenses include internal labor costs, costs to remediate certain inspectional observations made by the FDA at our Munich facility and costs associated with the incorporation of the modification of the 3T device design into the next generation 3T device. These costs are expensed as incurred and are not included within the product remediation liability presented above. For further information, please refer to “ Note 11. Commitments and Contingencies .” At this stage, we have recognized no liability with respect to any claims related to the 3T device and our related legal costs are expensed as incurred.

Investments

Investments	9 Months Ended
	Sep. 30, 2018
Investments [Abstract]
Investments	Note 7. Investments The following table details the carrying value of our investment in equity securities of non-consolidated affiliates without readily determinable fair values and are reported at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or similar investment of the same issuer. These equity positions in privately-held companies are included in “Investments” in the condensed consolidated balance sheets (in thousands): September 30, 2018 December 31, 2017 Respicardia Inc. (1) $ 17,706 $ 17,422 Ceribell, Inc. (2) 3,000 — ImThera Medical, Inc. (3) — 12,900 Rainbow Medical Ltd. (4) 1,134 1,172 MD Start II (5) 1,158 1,199 Highlife S.A.S. (6) 1,098 — Other 17 17 $ 24,113 $ 32,710 (1) Respicardia Inc. (“Respicardia”) is a privately funded U.S. company developing an implantable device designed to restore a more natural breathing pattern during sleep in patients with central sleep apnea by transvenously stimulating the phrenic nerve. We have a loan outstanding to Respicardia with a carrying amount of $0.6 million , as of September 30, 2018 , which is included in “Prepaid expenses and other current assets” in the condensed consolidated balance sheet. (2) On September 7, 2018, we acquired 1,007,319 shares of Series B Preferred Stock of Ceribell, Inc. (“Ceribell”). Ceribell is focused on utilizing electroencephalography to improve the diagnosis and treatment of patients at risk for seizures. (3) On January 16, 2018, we acquired the remaining outstanding interests in ImThera. Refer to “ Note 3. Business Combinations .” (4) Rainbow Medical Ltd. is a private Israeli venture capital company that seeds and grows companies developing medical devices in a diverse range of medical fields. (5) MD Start II is a private venture capital collaboration for the development of medical device technology in Europe. (6) Due to an additional investment by a third party during the nine months ended September 30, 2018 , our equity interest in Highlife S.A.S. (“Highlife”) decreased to 17.5% from 24.6% . We determined that we no longer had significant influence over Highlife and, as a result, we began to measure Highlife at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or similar investment of the same issuer. At December 31, 2017 , we accounted for Highlife under the equity method and the carrying value was $1.8 million .

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 8. Fair Value Measurements We review the fair value hierarchy classification on a quarterly basis. Changes in the ability to observe valuation inputs may result in a reclassification of levels for certain securities within the fair value hierarchy. There were no transfers between Level 1, Level 2, or Level 3 during the nine months ended September 30, 2018 . Assets and Liabilities Measured at Fair Value on a Recurring Basis The following table provides information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of September 30, 2018 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - freestanding instruments (foreign currency exchange rate “FX”) $ 3,309 $ — $ 3,309 $ — $ 3,309 $ — $ 3,309 $ — Liabilities: Derivative liabilities - designated as cash flow hedges FX $ 1,084 $ — $ 1,084 $ — Derivative liabilities - designated as cash flow hedges (interest rate swaps) 996 — 996 — Derivative liabilities - freestanding instruments FX 224 — 224 — Contingent consideration (1) 183,012 — — 183,012 $ 185,316 $ — $ 2,304 $ 183,012 Fair Value as of December 31, 2017 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - freestanding instruments (FX) $ 519 $ — $ 519 $ — $ 519 $ — $ 519 $ — Liabilities: Derivative liabilities - designated as cash flow hedges (FX) $ 460 $ — $ 460 $ — Derivative liabilities - designated as cash flow hedges (interest rate swaps) 1,585 — 1,585 — Contingent consideration (1) 33,973 — — 33,973 $ 36,018 $ — $ 2,045 $ 33,973 (1) The contingent consideration liability represents contingent payments related to five completed acquisitions: Cellplex PTY Ltd., Inversiones Drilltex SAS, Caisson, ImThera and TandemLife. See the table below for additional information. Our recurring fair value measurements, using significant unobservable inputs (Level 3), relate solely to our contingent consideration liability. The following table provides a reconciliation of the beginning and ending balance of the contingent consideration liability (in thousands): Total contingent consideration liability at December 31, 2017 $ 33,973 Purchase price - ImThera contingent consideration 112,744 Purchase price - TandemLife contingent consideration 40,190 Payments (2,661 ) Changes in fair value (1) (1,258 ) Effect of changes in foreign currency exchange rates 24 Total contingent consideration liability at September 30, 2018 183,012 Less current portion of contingent consideration liability at September 30, 2018 18,402 Long-term portion of contingent consideration liability at September 30, 2018 $ 164,610 (1) Includes a decrease of $3.8 million and $2.3 million recorded to cost of sales and R&D expenses, respectively, recognized during the second quarter of 2018 due to the delay in the timing of anticipated regulatory approval for ImThera. See “ Note 3. Business Combinations ” for additional discussion.

Financing Arrangements

Financing Arrangements	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Financing Arrangements	Note 9. Financing Arrangements The outstanding principal amount of long-term debt (in thousands, except interest rates): September 30, 2018 December 31, 2017 Maturity Interest Rate 2017 European Investment Bank (1) $ 60,000 $ — June 2026 3.35 % 2014 European Investment Bank (2) 57,903 69,893 June 2021 0.97 % Mediocredito Italiano (3) 8,383 9,118 December 2023 0.50% - 3.10% Banca del Mezzogiorno (4) 4,118 5,499 December 2019 0.50% - 3.15% Region Wallonne 752 845 December 2023 and June 2033 0.00% - 2.45% Mediocredito Italiano - mortgages and other 512 997 September 2021 and September 2026 0.80% - 1.30% Bpifrance (ex-Oséo) — 1,450 — 2.58 % Total long-term facilities 131,668 87,802 Less current portion of long-term debt 23,578 25,844 Total long-term debt $ 108,090 $ 61,958 (1) The 2017 European Investment Bank (“2017 EIB”) loan was obtained to support certain product development projects. The interest rate for the 2017 EIB loan is reset by the lender each principal payment date based on LIBOR. Interest payments are paid quarterly and principal payments are paid semi-annually. On July 30, 2018, we borrowed $60.0 million under the 2017 EIB loan. (2) The 2014 European Investment Bank (“2014 EIB”) loan was obtained in July 2014 to support certain product development projects. The interest rate for the 2014 EIB loan is reset by the lender each quarter based on the Euribor. Interest payments are paid quarterly and principal payments are paid semi-annually. (3) We obtained the Mediocredito Italiano Bank loan in July 2016 as part of the Fondo Innovazione Teconologica program implemented by the Italian Ministry of Education. (4) The Banca del Mezzogiorno loan was obtained in January 2015 to support R&D projects as a part of the Large Strategic Project program of the Italian Ministry of Education. Revolving Credit The outstanding principal amount of our short-term unsecured revolving credit agreements and other agreements with various banks was $25.4 million and $58.2 million , at September 30, 2018 and December 31, 2017 , respectively, with interest rates ranging from 0.5% to 9.3% and loan terms ranging from 30 days to 180 days . On April 10, 2018, we entered into an amendment and restatement agreement with Barclays Bank PLC amending the revolving facility agreement originally dated October 21, 2016 (the “Amendment”). The Amendment increases the borrowing capacity under the facility from $40.0 million to $70.0 million and extends the term of the facility one year, terminating October 20, 2019. Borrowings under the facility bear interest at a rate of LIBOR plus 0.85% . In connection with the CRM sale, on May 1, 2018, the borrowing capacity of the 2017 EIB loan decreased from €100.0 million (approximately $115.8 million as of September 30, 2018 ) to €90.0 million (approximately $104.2 million as of September 30, 2018 ). Bridge Facility Agreement In connection with the April 2018 acquisition of TandemLife, LivaNova entered into a bridge facility agreement (the “Bridge Facility Agreement”) providing a term loan facility with the aggregate principal amount of $190.0 million . On April 3, 2018, we borrowed $190.0 million under the Bridge Facility Agreement to facilitate the initial payment for our acquisition of TandemLife. We used the proceeds from the sale of the CRM business franchise to repay the borrowings under the Bridge Facility Agreement in full during the second quarter of 2018.

Derivatives and Risk Management

Derivatives and Risk Management	9 Months Ended
	Sep. 30, 2018
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives and Risk Management	Note 10. Derivatives and Risk Management Due to the global nature of our operations, we are exposed to foreign currency exchange rate fluctuations. In addition, due to certain loans with floating interest rates, we are also subject to the impact of changes in interest rates on our interest payments. We enter into foreign currency exchange rate (“FX”) derivative contracts and interest rate swap contracts to reduce the impact of foreign currency rate and interest rate fluctuations on earnings and cash flow. We measure all outstanding derivatives each period end at fair value and report the fair value as either financial assets or liabilities in the condensed consolidated balance sheets. We do not enter into derivative contracts for speculative purposes. At inception of the contract, the derivative is designated as either a freestanding derivative or a hedge. Derivatives that are not designated as hedging instruments are referred to as freestanding derivatives with changes in fair value included in earnings. If the derivative qualifies for hedge accounting, depending on the nature of the hedge and hedge effectiveness, changes in the fair value of the derivative will either be recognized immediately in earnings or recorded in accumulated other comprehensive income (“AOCI”) until the hedged item is recognized in earnings upon settlement/termination. FX derivative gains and losses in AOCI are reclassified to the condensed consolidated statements of income as shown in the tables below and interest rate swap gains and losses in AOCI are reclassified to interest expense in the condensed consolidated statements of income. We evaluate hedge effectiveness at inception and on an ongoing basis. If a derivative is no longer expected to be highly effective, hedge accounting is discontinued. Hedge ineffectiveness, if any, is recorded in earnings. Cash flows from derivative contracts are reported as operating activities in the condensed consolidated statements of cash flows. Freestanding Derivative FX Contracts The gross notional amount of FX derivative contracts, not designated as hedging instruments, outstanding at September 30, 2018 and December 31, 2017 was $229.3 million and $231.9 million , respectively. These derivative contracts are designed to offset the FX effects in earnings of various intercompany loans, our 2014 EIB loan, and trade receivables. We recorded net gains for these freestanding derivatives of $5.6 million for the three months ended September 30, 2018 , a loss of $0.7 million for the three months ended September 30, 2017 and net losses of $6.0 million and $7.9 million for the nine months ended September 30, 2018 and September 30, 2017 , respectively. The net gains and losses are included in “ Foreign exchange and other (losses) gains ” in the condensed consolidated statements of income. Cash Flow Hedges Notional amounts of open derivative contracts designated as cash flow hedges (in thousands): Description of Derivative Contract September 30, 2018 December 31, 2017 FX derivative contracts to be exchanged for British Pounds $ 8,256 $ 16,847 FX derivative contracts to be exchanged for Japanese Yen 13,712 32,302 FX derivative contracts to be exchanged for Canadian Dollars 14,053 16,494 FX derivative contracts to be exchanged for Euros 28,657 — Interest rate swap contracts 46,322 55,965 $ 111,000 $ 121,608 After-tax net loss associated with derivatives designated as cash flow hedges recorded in the ending balance of AOCI and the amount expected to be reclassified to earnings in the next twelve months (in thousands): Description of Derivative Contract After-tax net loss in AOCI as of September 30, 2018 Amount Expected to be Reclassified to Earnings in Next 12 Months FX derivative contracts $ (601 ) $ (601 ) Interest rate swap contracts (139 ) (51 ) $ (740 ) $ (652 ) During the nine months ended September 30, 2018 , we discontinued and settled certain of our FX derivative contracts due to changes in our foreign currency revenue forecast that resulted in a loss of $0.6 million reclassified to earnings from accumulated other comprehensive income (loss). Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in Other Comprehensive Income (Loss) (“OCI”) and the amount reclassified to earnings from AOCI (in thousands): Three Months Ended September 30, 2018 2017 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 125 $ 2,511 $ (2,537 ) $ (1,623 ) FX derivative contracts SG&A — (3,007 ) — 269 Interest rate swap contracts Interest expense — (72 ) — 797 $ 125 $ (568 ) $ (2,537 ) $ (557 ) Nine Months Ended September 30, 2018 2017 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 314 $ 1,999 $ (10,124 ) $ (6,833 ) FX derivative contracts SG&A — (1,833 ) — 1,623 Interest rate swap contracts Interest expense — (89 ) — 1,009 $ 314 $ 77 $ (10,124 ) $ (4,201 ) The following tables present the fair value on a gross basis, and the location of, derivative contracts reported in the condensed consolidated balance sheets (in thousands): September 30, 2018 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Interest rate swap contracts Prepaid expenses and other current assets $ — Accrued liabilities $ 487 Interest rate swap contracts Other assets — Other long-term liabilities 509 FX derivative contracts Prepaid expenses and other current assets — Accrued liabilities 1,084 Total derivatives designated as hedging instruments — 2,080 Derivatives Not Designated as Hedging Instruments FX derivative contracts Prepaid expenses and other current assets 3,309 Accrued liabilities 224 Total derivatives not designated as hedging instruments 3,309 224 Total derivatives $ 3,309 $ 2,304 December 31, 2017 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Interest rate swap contracts Prepaid expenses and other current assets $ — Accrued liabilities $ 834 Interest rate swap contracts Other assets — Other long-term liabilities 751 FX derivative contracts Prepaid expenses and other current assets — Accrued liabilities 460 Total derivatives designated as hedging instruments — 2,045 Derivatives Not Designated as Hedging Instruments FX derivative contracts Prepaid expenses and other current assets 519 Accrued liabilities — Total derivatives not designated as hedging instruments 519 — Total derivatives $ 519 $ 2,045 (1) For the classification of inputs used to evaluate the fair value of our derivatives, refer to “ Note 8. Fair Value Measurements .”

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2018
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 11. Commitments and Contingencies FDA Warning Letter On December 29, 2015, the FDA issued a Warning Letter alleging certain violations of FDA regulations applicable to medical device manufacturers at our Munich, Germany and Arvada, Colorado facilities. The FDA inspected the Munich facility from August 24, 2015 to August 27, 2015 and the Arvada facility from August 24, 2015 to September 1, 2015. On August 27, 2015, the FDA issued a Form 483 identifying two observed non-conformities with certain regulatory requirements at the Munich facility. We did not receive a Form 483 in connection with the FDA’s inspection of the Arvada facility. Following the receipt of the Form 483, we provided written responses to the FDA describing corrective and preventive actions that were underway or to be taken to address the FDA’s observations at the Munich facility. The Warning Letter responded in part to our responses and identified other alleged violations related to the manufacture of our 3T device that were not previously included in the Form 483. The Warning Letter further stated that our 3T devices and other devices we manufactured at our Munich facility are subject to refusal of admission into the U.S. until resolution of the issues set forth by the FDA in the Warning Letter. The FDA has informed us that the import alert is limited to the 3T devices, but that the agency reserves the right to expand the scope of the import alert if future circumstances warrant such action. The Warning Letter did not request that existing users cease using the 3T device, and manufacturing and shipment of all of our products other than the 3T device remain unaffected by the import limitation. To help clarify these issues for current customers, we issued an informational Customer Letter in January 2016 and that same month agreed with the FDA on a process for shipping 3T devices to existing U.S. users pursuant to a certificate of medical necessity program. Finally, the Warning Letter stated that premarket approval applications for Class III devices to which certain Quality System regulation deviations identified in the Warning Letter are reasonably related will not be approved until the violations have been corrected; however, this restriction applies only to the Munich and Arvada facilities, which do not manufacture or design devices subject to Class III premarket approval. We continue to work diligently to remediate the FDA’s inspectional observations for the Munich facility, as well as the additional issues identified in the Warning Letter. We take these matters seriously and intend to respond timely and fully to the FDA’s requests. CDC and FDA Safety Communications and Company Field Safety Notice Update On October 13, 2016, the CDC and the FDA separately released safety notifications regarding the 3T devices. The CDC’s Morbidity and Mortality Weekly Report (“MMWR”) and Health Advisory Notice (“HAN”) reported that tests conducted by CDC and its affiliates indicate that there appears to be genetic similarity between both patient and 3T device strains of the non-tuberculous mycobacterium (“NTM”) bacteria M. chimaera isolated in hospitals in Iowa and Pennsylvania. Citing the geographic separation between the two hospitals referenced in the investigation, the report asserts that 3T devices manufactured prior to August 18, 2014 could have been contaminated during the manufacturing process. The CDC’s HAN and FDA’s Safety Communication, issued contemporaneously with the MMWR report, each assess certain risks associated with 3T devices and provide guidance for providers and patients. The CDC notification states that the decision to use the 3T device during a surgical operation is to be taken by the surgeon based on a risk approach and on patient need. Both the CDC’s and FDA’s communications confirm that 3T devices are critical medical devices and enable doctors to perform life-saving cardiac surgery procedures. Also on October 13, 2016, in response to the Warning Letter and CDC’s HAN and FDA’s Safety Communication, we issued a Field Safety Notice Update for U.S. users of 3T devices to proactively and voluntarily contact facilities to aid in implementation of the CDC and FDA recommendations. In the fourth quarter of 2016, we initiated a program to provide existing 3T device users with a new loaner 3T device at no charge pending regulatory approval and implementation of additional risk mitigation strategies worldwide, including a vacuum canister and internal sealing upgrade program and a deep disinfection service. This loaner program began in the U.S. and is being made available progressively on a global basis, prioritizing and allocating devices to 3T device users based on pre-established criteria. We anticipate that this program will continue until we are able to address customer needs through a broader solution that includes implementation of the risk mitigation strategies described above. We are currently implementing the vacuum and sealing upgrade program in as many countries as possible until all devices are upgraded. On October 11, 2018, after review of information provided by LivaNova, the FDA concluded that LivaNova could commence the vacuum and sealing upgrade program in the U.S. Furthermore, we continue to offer a no-charge deep disinfection service (deep cleaning service) for 3T device users as we receive the required regulatory approvals. On April 12, 2018, the FDA agreed to allow us to move forward with the deep cleaning service in the U.S. adding to the growing list of countries around the world in which we offer this service. On December 31, 2016, we recognized a liability for our product remediation plan related to our 3T device. We concluded that it was probable that a liability had been incurred upon management’s approval of the plan and the commitments made by management to various regulatory authorities globally in November and December 2016, and furthermore, the cost associated with the plan was reasonably estimable. At September 30, 2018 , the product remediation liability was $17.9 million . Refer to “ Note 6. Product Remediation Liability ” for additional information. Litigation Product Liability The Company is currently involved in litigation involving our 3T device. The litigation includes a class action complaint in the U.S. District Court for the Middle District of Pennsylvania, federal multi-district litigation in the U.S. District Court for the Middle District of Pennsylvania, various U.S. state court cases and cases in jurisdictions outside the U.S. As of October 31, 2018, we are involved in approximately 150 claims worldwide, with the majority of the claims in various federal or state courts throughout the United States. The complaints generally seek damages and other relief based on theories of strict liability, negligence, breach of express and implied warranties, failure to warn, design and manufacturing defect, fraudulent and negligent misrepresentation/concealment, unjust enrichment, and violations of various state consumer protection statutes. The class action, filed in February 2016, consists of all Pennsylvania residents who underwent open heart surgery at WellSpan York Hospital and Penn State Milton S. Hershey Medical Center between 2011 and 2015 and who currently are asymptomatic for NTM infection. Members of the class seek declaratory relief that the 3T devices are defective and unsafe for intended uses, medical monitoring, damages, and attorneys’ fees. The class action and cases in federal court have been stayed as a result of the federal multi-district litigation. However, cases in state courts in the U.S. and in jurisdictions outside the U.S continue to progress. We have not recognized an expense related to damages in connection with these matters because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from these matters. Civil Investigative Demand On May 31, 2017, the Company received a Civil Investigative Demand (“CID”) from the US Attorney’s Office for the Northern District of Georgia. The CID requested, and we have provided, certain documents relating to the sales and marketing of VNS devices and related products in the State of Georgia. On October 25, 2018, without an admission of guilt, we entered into a settlement agreement with the US Department of Justice, the State of Georgia, and a former Company employee, and agreed to pay approximately $1.9 million . Accordingly, during the three months ended September 30, 2018 we recognized $1.9 million in selling, general and administrative expenses reflecting settlement of this matter. Environmental Liability SNIA Litigation Our subsidiary, Sorin S.p.A. (“Sorin”) was created as a result of a spin-off (the “Sorin spin-off”) from SNIA S.p.A. (“SNIA”) in January, 2004. SNIA subsequently became insolvent and the Italian Ministry of the Environment and the Protection of Land and Sea (the “Italian Ministry of the Environment”), sought compensation from SNIA in an aggregate amount of approximately $4 billion for remediation costs relating to the environmental damage at chemical sites previously operated by SNIA’s other subsidiaries. In September 2011 and July 2014, the Bankruptcy Court of Udine and the Bankruptcy Court of Milan held (in proceedings to which we are not parties) that the Italian Ministry of the Environment and other Italian government agencies (the “Public Administrations”) were not creditors of either SNIA or its subsidiaries in connection with their claims in the Italian insolvency proceedings. The Public Administrations appealed and in January 2016, the Court of Udine rejected the appeal. The Public Administrations have also appealed that decision. In January 2012, SNIA filed a civil action against Sorin in the Civil Court of Milan asserting joint liability of a parent and a spun-off company. On April 1, 2016, the Court of Milan dismissed all legal actions of SNIA and of the Public Administrations further requiring the Public Administrations to pay Sorin approximately $338,000 for legal fees. The Public Administrations appealed the 2016 Decision to the Court of Appeal of Milan and a final decision is pending. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter. Environmental Remediation Order On July 28, 2015, Sorin received an administrative order (the “Remediation Order”) from the Italian Ministry of the Environment directing prompt commencement of environmental remediation at the chemical sites previously operated by SNIA’s other subsidiaries. We challenged the Remediation Order before the Administrative Court of Lazio in Rome (the “TAR”), and the TAR annulled the Remediation Order. The Italian Ministry of the Environment appealed to the Administrative Court of Appeal. On August 22, 2018, the Court of Appeals confirmed the decision and ordered the Public Administrations to bear court expenses of approximately $5,000 . The Public Administrations have six months to determine whether they will attempt an appeal to the Supreme Court. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter. Opposition to Merger Proceedings On July 28, 2015, the Public Administrations filed an opposition proceeding to the merger between Sorin and Cyberonics, Inc. (the “Merger”), before the Commercial Courts of Milan. The Court authorized the Merger and the Public Administrations did not appeal this decision. The proceeding then continued as a civil case, with the Public Administrations seeking damages. The Commercial Court of Milan delivered a decision in October 2016, fully rejecting the Public Administrations’ request and awarding us approximately $480,000 in damages for frivolous litigation and legal fees. The Public Administrations appealed to the Court of Appeal of Milan. On May 15, 2018, the Court of Appeal of Milan confirmed its decision authorizing the Merger, but reduced the penalty of $480,000 in damages for frivolous litigation and legal fees to $58,000 for legal fees. The Public Administrations subsequently filed an appeal with the Supreme Court against the decision of the Court of Appeal of Milan. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter. Patent Litigation On May 11, 2018, Neuro and Cardiac Technologies LLC (“NCT”), a non-practicing entity, filed a complaint in the United States District Court for the Southern District of Texas asserting that the VNS Therapy System, when used with the SenTiva Model 1000 generator, infringes the claims of U.S. Patent No. 7,076,307 owned by NCT. The complaint requests damages that include a royalty, costs, interest, and attorneys’ fees. On September 13, 2018, we petitioned the Patent Trial and Appeal Board of the U. S. Patent and Trademark Office for an inter partes review (“IPR”) of the validity of the ‘307 patent. The Court has stayed the litigation pending the outcome of the IPR proceeding. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter. Tax Litigation In a tax audit report received October 30, 2009, the Regional Internal Revenue Office of Lombardy (the “Internal Revenue Office”) informed Sorin Group Italia S.r.l. that, among several issues, it was disallowing in part (for a total of €102.6 million (approximately $118.8 million ), related to tax years 2002 through 2006) a tax-deductible write down of the investment in the U.S. company, Cobe Cardiovascular Inc., which Sorin Group Italia S.r.l. recognized in 2002 and deducted in five equal installments, beginning in 2002. In December 2009, the Internal Revenue Office issued notices of assessment for 2002, 2003 and 2004. The assessments for 2002 and 2003 were automatically voided for lack of merit. In December 2010 and October 2011, the Internal Revenue Office issued notices of assessment for 2005 and 2006, respectively. We challenged all three notices of assessment (for 2004, 2005 and 2006) before the relevant Provincial Tax Courts. The preliminary challenges filed for 2004, 2005 and 2006 were denied at the first jurisdictional level. We appealed these decisions. The appeal submitted against the first-level decision for 2004 was successful. The Internal Revenue Office appealed this second-level decision to the Italian Supreme Court (Corte di Cassazione) on February 3, 2017. The Italian Supreme Court’s decision is pending. The appeals submitted against the first-level decisions for 2005 and 2006 were rejected. We appealed these adverse decisions to the Italian Supreme Court, where the matters are still pending. In November 2012, the Internal Revenue Office served a notice of assessment for 2007, and in July 2013, served a notice of assessment for 2008. In these matters the Internal Revenue Office claims an increase in taxable income due to a reduction (similar to the previous notices of assessment for 2004, 2005 and 2006) of the losses reported by Sorin Group Italia S.r.l. for the 2002, 2003 and 2004 tax periods, and subsequently utilized in 2007 and 2008. We challenged both notices of assessment. The Provincial Tax Court of Milan has stayed its decision for years 2007 and 2008 pending resolution of the litigation regarding years 2004, 2005, and 2006. The total amount of losses in dispute is €62.6 million (approximately $72.5 million ). We have continuously reassessed our potential exposure in these matters, taking into account the recent, and generally adverse, trend to Italian taxpayers in this type of litigation. Although we believe that our defensive arguments are strong, noting the adverse trend in some of the court decisions, we have recognized a reserve for an uncertain tax position of €17.0 million (approximately $19.6 million as of September 30, 2018 ). Other Matters Additionally, we are the subject of various pending or threatened legal actions and proceedings that arise in the ordinary course of our business. These matters are subject to many uncertainties and outcomes that are not predictable and that may not be known for extended periods of time. Since the outcome of these matters cannot be predicted with certainty, the costs associated with them could have a material adverse effect on our consolidated net income, financial position or liquidity.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2018
Stockholders' Equity Note [Abstract]
Stockholders' Equity	Note 12. Stockholders’ Equity The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income for the nine months ended September 30, 2018 and September 30, 2017 (in thousands): Change in Unrealized Gain (Loss) on Derivatives Foreign Currency Translation Adjustments Gain (Loss) ( 1) Total As of December 31, 2017 $ (919 ) $ 46,232 $ 45,313 Other comprehensive income (loss) before reclassifications, before tax 314 (36,727 ) (36,413 ) Tax expense (75 ) — (75 ) Other comprehensive income (loss) before reclassifications, net of tax 239 (36,727 ) (36,488 ) Reclassification of gain from accumulated other comprehensive income, before tax (77 ) (9,011 ) (2) (9,088 ) Reclassification of tax expense 18 — 18 Reclassification of gain from accumulated other comprehensive income, after tax (59 ) (9,011 ) (9,070 ) Net current-period other comprehensive income (loss), net of tax 180 (45,738 ) (45,558 ) As of September 30, 2018 $ (739 ) $ 494 $ (245 ) As of December 31, 2016 $ 3,619 $ (72,106 ) $ (68,487 ) Other comprehensive (loss) income before reclassifications, before tax (10,124 ) 111,123 100,999 Tax benefit 2,784 — 2,784 Other comprehensive (loss) income before reclassifications, net of tax (7,340 ) 111,123 103,783 Reclassification of loss from accumulated other comprehensive income, before tax 4,201 — 4,201 Reclassification of tax benefit (1,028 ) — (1,028 ) Reclassification of loss from accumulated other comprehensive income, after tax 3,173 — 3,173 Net current-period other comprehensive (loss) income, net of tax (4,167 ) 111,123 106,956 As of September 30, 2017 $ (548 ) $ 39,017 $ 38,469 (1) Taxes are not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned. (2) Cumulative foreign currency translation adjustments eliminated upon the sale of CRM.

Stock-Based Incentive Plans

Stock-Based Incentive Plans	9 Months Ended
	Sep. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Incentive Plans	Note 13. Stock-Based Incentive Plans Stock-based incentive plans compensation expense (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Service-based stock appreciation rights ("SARs") $ 2,491 $ 2,433 $ 6,514 $ 5,764 Service-based restricted stock units ("RSUs") 3,368 2,135 8,158 6,453 Market performance-based restricted stock units 509 289 1,814 463 Operating performance-based restricted stock units 909 611 2,941 1,018 Total stock-based compensation expense $ 7,277 $ 5,468 $ 19,427 $ 13,698 During the nine months ended September 30, 2018 , we issued stock-based compensatory awards with contract terms agreed upon by us and the respective individuals, as approved by the Compensation Committee of our Board of Directors. The awards with service conditions generally vest ratably over four years, subject to forfeiture unless service conditions are met. Market performance-based awards cliff vest after three years subject to the rank of our total shareholder return for the three -year period ending December 31, 2020 relative to the total shareholder returns for a peer group of companies. Operating performance-based awards cliff vest after three years subject to the achievement of certain thresholds of cumulative adjusted free cash flow for the three year period ending December 31, 2020. Compensation expense related to awards granted during 2018 for the three and nine months ended September 30, 2018 was $3.4 million and $7.3 million , respectively. Stock-based compensation agreements issued during the nine months ended September 30, 2018 , representing potential shares and their weighted average grant date fair values by type follows (shares in thousands, fair value in dollars): Nine Months Ended September 30, 2018 Shares Weighted Average Grant Date Fair Value Service-based SARs 648 $ 28.13 Service-based RSUs 255 $ 95.61 Market performance-based RSUs 43 $ 101.50 Operating performance-based RSUs 43 $ 89.74

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2018
Income Tax Disclosure [Abstract]
Income Taxes	Note 14. Income Taxes Our effective income tax rate from continuing operations for the three months ended September 30, 2018 was 29.8% compared with 6.5% for the three months ended September 30, 2017 . For the nine months ended September 30, 2018 , the effective income tax rate from continuing operations was 0.6% compared with 9.6% for the nine months ended September 30, 2017 . Our effective income tax rate fluctuates based on, among other factors, changes in pretax income in countries with varying statutory tax rates, changes in valuation allowances, changes in tax credits and incentives, and changes in unrecognized tax benefits associated with uncertain tax positions. Compared with the three months ended September 30, 2017, the increase in the effective tax rate for the three months ended September 30, 2018 was primarily attributable to the impact of several discrete tax benefits recorded during the three months ended September 30, 2017, including a net $4.0 million deferred tax benefit due to the release of valuation allowances on tax losses upon the completion of a reorganization of our legal entities in the U.S. and a $2.1 million deferred tax benefit from the resolution of prior period tax matters. Compared with the nine months ended September 30, 2017, the decrease in the effective tax rate for the nine months ended September 30, 2018 was primarily attributable to the impact of the reduction to the U.S. federal statutory tax rate as a result of the U.S. “Tax Cuts and Jobs Act” (the “Tax Act”), the benefit of foreign derived intangible income partially offset by the repeal of the U.S. domestic production activity deduction, certain tax law changes in the UK that occurred during the three months ended December 31, 2017 and the impact of discrete tax items. During the second quarter of 2018, we entered into an audit settlement impacting one of our uncertain tax positions in Italy. This audit settlement resulted in the recognition of an additional $1.7 million in income tax expense. Further regulations and notices and state conformity could be issued as a result of U.S. tax reform covering various issues that may affect our tax position including, but not limited to, an increase in the corporate state tax rate and elimination of the interest deduction. The content of any future legislation, the timing for regulations, notices, and state conformity, and the reporting periods that would be impacted cannot be determined at this time. During the nine months ended September 30, 2018, the Company did not record material adjustments to the $27.5 million provisional non-cash net charge recorded in the fourth quarter of 2017 related to the Tax Act.

Net Income (Loss) Per Share

Net Income (Loss) Per Share	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Income (Loss) Per Share	Note 15. Net Income (Loss) Per Share Reconciliation of the shares used in the basic and diluted earnings per share computations for the three and nine months ended September 30, 2018 and September 30, 2017 are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Basic weighted average shares outstanding 48,637 48,181 48,484 48,130 Add effects of share-based compensation instruments (1) — 353 943 209 Diluted weighted average shares outstanding 48,637 48,534 49,427 48,339 (1) Excluded from the computation of diluted earnings per share for the three months ended September 30, 2018 were stock options, SARs and restricted share units totaling 2.8 million , because to include them would be anti-dilutive under the treasury stock method due to the net loss. Excluded from the computation of diluted earnings per share for the nine months ended September 30, 2018 were stock options, SARs and restricted share units totaling 0.5 million because to include them would be anti-dilutive under the treasury stock method. Excluded from the computation of diluted earnings per share for the three and nine months ended September 30, 2017 were stock options, SARs and restricted share units totaling 1.6 million , because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Informat

Geographic and Segment Information	9 Months Ended
	Sep. 30, 2018
Segment Reporting [Abstract]
Geographic and Segment Information	Note 16. Geographic and Segment Information We identify operating segments based on the way we manage, evaluate and internally report our business activities for purposes of allocating resources and assessing performance. We have two reportable segments: Cardiovascular and Neuromodulation. The Cardiovascular segment generates its revenue from the development, production and sale of cardiopulmonary products, heart valves and advanced circulatory support. Cardiopulmonary products include oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Heart valves include mechanical heart valves, tissue heart valves and related repair products. Advanced circulatory support, which represents our recently acquired TandemLife business, includes temporary life support product kits that can include a combination of pumps, oxygenators, and cannulae. The Neuromodulation segment generates its revenue from the design, development and marketing of neuromodulation therapy systems for the treatment of drug-resistant epilepsy and treatment-resistant depression. Neuromodulation products include the VNS Therapy System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. On January 16, 2018, we acquired the remaining 86% outstanding interest in ImThera which is also included in our Neuromodulation segment. ImThera manufactures an implantable device for the treatment of obstructive sleep apnea that stimulates multiple tongue muscles via the hypoglossal nerve, which opens the airway while a patient is sleeping. “Other” includes corporate shared service expenses for finance, legal, human resources and information technology and corporate business development (“New Ventures”). New Ventures is focused on new growth platforms and identification of other opportunities for expansion. Effective January 1, 2018, we began to include the results of heart failure within the Neuromodulation segment for internal reporting purposes in order to manage and evaluate business activities for purposes of allocating resources and assessing performance. Previously, the results of heart failure were reported within “Other”. Segment results for the three and nine months ended September 30, 2017 have been recast to conform to the current period presentation. Net sales of our reportable segments include revenues from the sale of products they each develop and manufacture or distribute. We define segment income as operating income before merger and integration, restructuring and amortization of intangibles. We operate under three geographic regions: United States, Europe, and Rest of world. The table below presents net sales by operating segment and geographic region (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Cardiopulmonary United States $ 40,396 $ 38,379 $ 120,980 $ 110,274 Europe 32,186 30,520 104,972 95,088 Rest of world 55,358 54,665 163,757 149,645 127,940 123,564 389,709 355,007 Heart Valves United States 6,145 6,612 18,828 18,886 Europe 9,421 9,909 33,400 30,940 Rest of world 16,980 19,737 45,162 52,779 32,546 36,258 97,390 102,605 Advanced Circulatory Support United States 5,947 — 11,415 — Europe 38 — 391 — Rest of world 90 — 284 — 6,075 — 12,090 — Cardiovascular United States 52,488 44,991 151,223 129,160 Europe 41,645 40,429 138,763 126,028 Rest of world 72,428 74,402 209,203 202,424 166,561 159,822 499,189 457,612 Neuromodulation United States 87,194 76,286 254,581 231,350 Europe 9,497 8,057 31,731 25,500 Rest of world 8,252 6,673 23,128 18,340 104,943 91,016 309,440 275,190 Other 578 415 1,349 1,119 Totals United States 139,682 121,277 405,804 360,510 Europe (1) 51,142 48,486 170,494 151,528 Rest of world 81,258 81,490 233,680 221,883 Total (2) $ 272,082 $ 251,253 $ 809,978 $ 733,921 (1) Europe sales include those countries in which we have a direct sales presence, whereas European countries in which we sell through distributors are included in Rest of world. (2) No single customer represented over 10% of our consolidated net sales. No country’s net sales exceeded 10% of our consolidated sales except for the U.S. Operating income by segment is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Operating Income from Continuing Operations 2018 2017 2018 2017 Cardiovascular $ 9,783 $ 23,788 $ 36,378 $ 63,594 Neuromodulation 36,432 46,524 132,377 138,544 Other (29,420 ) (28,557 ) (89,479 ) (78,460 ) Total reportable segment income from continuing operations 16,795 41,755 79,276 123,678 Merger and integration expenses 12,659 2,010 20,028 7,708 Restructuring expenses 436 1,183 2,793 13,810 Amortization of intangibles 9,457 8,540 28,075 24,616 Operating (loss) income from continuing operations $ (5,757 ) $ 30,022 $ 28,380 $ 77,544 Assets by reportable segment (in thousands): Assets September 30, 2018 December 31, 2017 Cardiovascular $ 1,548,866 $ 1,386,032 Neuromodulation 762,375 532,894 Other 299,439 334,276 Discontinued operations — 250,689 Total assets $ 2,610,680 $ 2,503,891 Capital expenditures by segment (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Capital expenditures 2018 2017 2018 2017 Cardiovascular $ 8,032 $ 5,541 $ 15,757 $ 13,292 Neuromodulation 512 370 1,359 2,348 Other 4,359 1,633 7,058 4,021 Discontinued operations — 1,537 925 4,343 Total $ 12,903 $ 9,081 $ 25,099 $ 24,004 The changes in the carrying amount of goodwill by reportable segment for the nine months ended September 30, 2018 were as follows (in thousands): Neuromodulation Cardiovascular Other Total December 31, 2017 $ 315,943 $ 425,882 $ 42,417 $ 784,242 Goodwill as a result of acquisitions (1) 82,596 121,688 — 204,284 Foreign currency adjustments — (19,249 ) — (19,249 ) September 30, 2018 $ 398,539 $ 528,321 $ 42,417 $ 969,277 (1) Goodwill recognized as a result of the ImThera and TandemLife acquisitions. Refer to “ Note 3. Business Combinations .” Property, plant and equipment, net by geography are as follows (in thousands): PP&E September 30, 2018 December 31, 2017 United States $ 65,776 $ 62,154 Europe 112,092 119,133 Rest of world 10,592 11,072 Total $ 188,460 $ 192,359

Supplemental Financial Informat

Supplemental Financial Information	9 Months Ended
	Sep. 30, 2018
Balance Sheet Related Disclosures [Abstract]
Supplemental Financial Information	Note 17. Supplemental Financial Information Inventories consisted of the following (in thousands): September 30, 2018 December 31, 2017 Raw materials $ 37,839 $ 39,810 Work-in-process 20,321 18,206 Finished goods 94,896 86,454 $ 153,056 $ 144,470 Inventories are reported net of the provision for obsolescence. This provision, which reflects normal obsolescence and includes components that are phased out or expired, totaled $11.5 million and $10.5 million at September 30, 2018 and December 31, 2017 , respectively. Accrued liabilities and other consisted of the following (in thousands): September 30, 2018 December 31, 2017 Contingent consideration (1) $ 18,402 $ — Product remediation (2) 15,509 16,811 CRM purchase price adjustment payable to MicroPort Scientific Corporation 14,891 — Legal and administrative costs 13,041 6,082 Other amounts payable to MicroPort Scientific Corporation 11,419 — Deferred consideration - Caisson — 14,300 Other accrued expenses 45,471 41,749 $ 118,733 $ 78,942 (1) Refer to “ Note 8. Fair Value Measurements ” (2) Refer to “ Note 6. Product Remediation Liability ”

New Accounting Pronouncements

New Accounting Pronouncements	9 Months Ended
	Sep. 30, 2018
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
New Accounting Pronouncements	Note 18. New Accounting Pronouncements In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments-Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities . Update 2016-01 requires equity investments that do not result in consolidation and are not accounted for under the equity method to be measured at fair value with changes recognized in net income. However, an entity may elect to measure equity investments that do not have readily determinable fair values at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for an identical or a similar investment of the same issuer. We made this election beginning January 1, 2018, resulting in no material impact to our consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, Leases and later issued subsequent amendments to the initial guidance: ASU 2017-13, ASU 2018-10 and ASU 2018-11 (collectively, Topic 842). This guidance requires lessees to recognize most leases on the balance sheet as lease liabilities with corresponding right-of-use assets and to provide enhanced disclosures. We currently expect the majority of our operating lease commitments will be subject to the new standard, which we expect will increase the total assets and total liabilities that we report for these lease commitments by a material amount. The guidance provides certain practical expedients including an option to apply transition provisions of the new standard, including its disclosure requirements, at its adoption date instead of at the beginning of the earliest comparative period presented. We are in the process of assessing available practical expedients, including the transition provision that we have elected to apply, implementing lease accounting software and evaluating the effect this standard will have on our consolidated financial statements and related disclosures. The standard will be effective for us on January 1, 2019. In June 2016, the FASB issued ASU Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected. The amendments in this update are effective for annual periods beginning after December 15, 2019, including interim periods within those fiscal years. Early adoption is permitted as of the fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. The modified-retrospective approach is generally applicable through a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. We are currently evaluating the effect this standard will have on our consolidated financial statements and related disclosures. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments. Update 2016-15 provides guidance on the presentation and classification of certain cash receipts and cash payments in the statement of cash flows. We adopted this update on January 1, 2018 resulting in no material impact to our consolidated statements of cash flows. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . This update simplifies the accounting for the income tax consequences of transfers of assets from one unit of a corporation to another unit or subsidiary by eliminating an accounting exception that prevents the recognition of current and deferred income tax consequences for such “intra-entity transfers” until the assets have been sold to an outside party. We adopted this update on January 1, 2018 and recognized the following balance sheet adjustments (in thousands): Balance at December 31, 2017 Adjustment due to ASU No. 2016-16 Balance at January 1, 2018 Assets Prepaid expenses and other current assets $ 39,037 $ (12,604 ) $ 26,433 Deferred tax assets, net 11,559 58,301 69,860 Other assets 75,984 (68,127 ) 7,857 Equity Accumulated deficit $ (39,664 ) $ (22,430 ) $ (62,094 ) In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment . This update removes step 2 of the goodwill impairment test that compares the implied fair value of goodwill with its carrying amount. Instead, an impairment test is performed by comparing the fair value of a reporting unit with its carrying amount. An impairment charge will be recorded by the amount a reporting unit’s carrying amount exceeds its fair value. The update is effective for annual periods after December 15, 2019, including interim periods within those annual reporting periods with early adoption permitted. In March 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business . This update clarifies when a set of assets and activities is a business. We adopted this update on January 1, 2018. The ImThera and TandemLife acquisitions were considered acquisitions of a business. Refer to “ Note 3. Business Combinations ” for a discussion of our acquisitions of ImThera and TandemLife. In March 2017, the FASB issued ASU No. 2017-07, Compensation—Retirement Benefits (Topic 715): Improving the Presentation of Net Periodic Pension Cost and Net Periodic Post Retirement Benefit Cost . This update requires that an employer report the service cost component in the same line item or items as other compensation costs arising from services rendered by the pertinent employees during the period. We adopted this update on January 1, 2018, resulting in an immaterial impact to our consolidated financial statements. The condensed consolidated statements of income for the three and nine months ended September 30, 2017 have been recast for the adoption of this update. In June 2018, the FASB issued ASU No. 2018-07, Compensation—Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting. This update simplifies the accounting for non-employee share-based payment transactions. The amendment specifies that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in a grantor’s own operations by issuing share-based payment awards. The update is effective for annual periods after December 15, 2018, including interim periods within those annual reporting periods with early adoption permitted. We do not expect the adoption of this update to have a material effect on our consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Changes to the Disclosure Requirements for Fair Value Measurement . This update removes, modifies and adds certain disclosure requirements related to fair value measurements. The update is effective for annual periods after December 15, 2019, including interim periods within those annual reporting periods with early adoption permitted. We do not expect the adoption of this update to have a material effect on our consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-14, Compensation—Retirement Benefits—Defined Benefit Plans—General (Subtopic 715-20): Changes to the Disclosure Requirements for Defined Benefit Plans . This update adds and removes certain disclosure requirements related to defined benefit plans. The update is effective for annual periods after December 15, 2020, on a retrospective basis for all periods presented with early adoption permitted. We do not expect the adoption of this update to have a material effect on our consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract. This update clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. This update is effective for annual periods after December 15, 2019, including interim periods within those annual reporting periods with early adoption permitted and should be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. We do not expect the adoption of this update to have a material effect on our consolidated financial statements.

Unaudited Condensed Consolida_2

Unaudited Condensed Consolidated Financial Statements (Policies)	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Basis of Presentation	The accompanying condensed consolidated financial statements of LivaNova as of, and for the three and nine months ended September 30, 2018 and September 30, 2017 , have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2017 has been derived from audited financial statements contained in our 2017 Form 10-K, but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments (consisting of only normal recurring adjustments) considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries, for the three and nine months ended September 30, 2018 and are not necessarily indicative of the results that may be expected for the year ending December 31, 2018 . The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying our 2017 Form 10-K.
Revenue Recognition	Products and Services The Cardiovascular (“CV”) segment has three primary product lines: cardiopulmonary products, heart valves and advanced circulatory support. Cardiopulmonary products include oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Heart valves include mechanical heart valves, tissue heart valves and related repair products. Advanced circulatory support, which represents our recently acquired TandemLife business, includes temporary life support product kits that can include a combination of pumps, oxygenators, and cannulae. Cardiopulmonary products may include performance obligations associated with assembly and installation of equipment. Accordingly, we allocate a portion of the sales prices to installation obligations and recognize that revenue when the service is provided. We recognize revenue for equipment and accessory product sales when control of the equipment or product passes to the customer. Heart valve revenue is recognized when control passes to the customer, usually at the point of surgery. Advanced circulatory support revenue is recognized when control passes to the customer, usually at the point of shipment. Technical services include installation, repair and maintenance of cardiopulmonary equipment under service contracts or upon customer request. Technical service agreements generally provide for upfront payments in advance of rendering services or periodic billing over the contract term. Amounts billed in advance are deferred and recognized as revenue when the performance obligation is satisfied. Technical services are not a significant component of CV revenue and have been presented with the related equipment and accessories revenue. Neuromodulation Products The Neuromodulation (“NM”) segment generates its revenue from the sale of neuromodulation therapy systems for the treatment of drug-resistant epilepsy, treatment-resistant depression and obstructive sleep apnea. The NM product line includes the VNS Therapy System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. The NM product line also includes an implantable device for the treatment of obstructive sleep apnea that stimulates multiple tongue muscles via the hypoglossal nerve, which opens the airway while a patient is sleeping. We recognize revenue for NM product sales when control passes to the customer. Contract Balances Due to the nature of our products and services, revenue producing activities may result in contract assets and contract liabilities which are insignificant to our financial position and results of operations. These activities relate primarily to CV technical services contracts for short-term and multi-year service agreements. Contract assets are primarily comprised of unbilled revenues, which occur when a performance obligation has been completed, but not billed to the customer. Contract liabilities are made up of deferred revenue, which occurs when a customer pays for a service, before a performance obligation has been completed. We generate our revenue through contracts with customers that primarily consist of hospitals, healthcare institutions, distributors and other organizations. Revenue is measured based on consideration specified in a contract with a customer, and excludes amounts collected on behalf of third parties. We measure the consideration based upon the estimated amount to be received. The amount of consideration we ultimately receive varies depending upon the return terms, sales rebates, discounts, and other incentives that we may offer, which are accounted for as variable consideration when estimating the amount of revenue to recognize. The estimate of variable consideration requires significant judgment. We have historically experienced a low rate of product returns and the total dollar value of product returns has not been significant to our financial statements. We recognize revenue when a performance obligation is satisfied by transferring the control of a product or providing service to a customer. Some of our contracts include the purchase of multiple products and/or services. In such cases, we allocate the transaction price based upon the relative estimated stand-alone price of each product and/or service sold. We record state and local sales taxes net; that is, we exclude sales tax from revenue. Typically, our contracts do not have a significant financing component. We incur incremental commission fees paid to the sales force associated with the sale of products. We apply the practical expedient within ASC 606-10-50-22 and have elected to recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset the entity would otherwise recognize is one year or less. As a result, no commissions are capitalized as contract costs at September 30, 2018 . The following is a description of the principal activities (separated by reportable segments) from which we generate our revenue.
Derivatives	Due to the global nature of our operations, we are exposed to foreign currency exchange rate fluctuations. In addition, due to certain loans with floating interest rates, we are also subject to the impact of changes in interest rates on our interest payments. We enter into foreign currency exchange rate (“FX”) derivative contracts and interest rate swap contracts to reduce the impact of foreign currency rate and interest rate fluctuations on earnings and cash flow. We measure all outstanding derivatives each period end at fair value and report the fair value as either financial assets or liabilities in the condensed consolidated balance sheets. We do not enter into derivative contracts for speculative purposes. At inception of the contract, the derivative is designated as either a freestanding derivative or a hedge. Derivatives that are not designated as hedging instruments are referred to as freestanding derivatives with changes in fair value included in earnings. If the derivative qualifies for hedge accounting, depending on the nature of the hedge and hedge effectiveness, changes in the fair value of the derivative will either be recognized immediately in earnings or recorded in accumulated other comprehensive income (“AOCI”) until the hedged item is recognized in earnings upon settlement/termination. FX derivative gains and losses in AOCI are reclassified to the condensed consolidated statements of income as shown in the tables below and interest rate swap gains and losses in AOCI are reclassified to interest expense in the condensed consolidated statements of income. We evaluate hedge effectiveness at inception and on an ongoing basis. If a derivative is no longer expected to be highly effective, hedge accounting is discontinued. Hedge ineffectiveness, if any, is recorded in earnings. Cash flows from derivative contracts are reported as operating activities in the condensed consolidated statements of cash flows.
New Accounting Pronouncements	In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments-Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities . Update 2016-01 requires equity investments that do not result in consolidation and are not accounted for under the equity method to be measured at fair value with changes recognized in net income. However, an entity may elect to measure equity investments that do not have readily determinable fair values at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for an identical or a similar investment of the same issuer. We made this election beginning January 1, 2018, resulting in no material impact to our consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, Leases and later issued subsequent amendments to the initial guidance: ASU 2017-13, ASU 2018-10 and ASU 2018-11 (collectively, Topic 842). This guidance requires lessees to recognize most leases on the balance sheet as lease liabilities with corresponding right-of-use assets and to provide enhanced disclosures. We currently expect the majority of our operating lease commitments will be subject to the new standard, which we expect will increase the total assets and total liabilities that we report for these lease commitments by a material amount. The guidance provides certain practical expedients including an option to apply transition provisions of the new standard, including its disclosure requirements, at its adoption date instead of at the beginning of the earliest comparative period presented. We are in the process of assessing available practical expedients, including the transition provision that we have elected to apply, implementing lease accounting software and evaluating the effect this standard will have on our consolidated financial statements and related disclosures. The standard will be effective for us on January 1, 2019. In June 2016, the FASB issued ASU Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected. The amendments in this update are effective for annual periods beginning after December 15, 2019, including interim periods within those fiscal years. Early adoption is permitted as of the fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. The modified-retrospective approach is generally applicable through a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. We are currently evaluating the effect this standard will have on our consolidated financial statements and related disclosures. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments. Update 2016-15 provides guidance on the presentation and classification of certain cash receipts and cash payments in the statement of cash flows. We adopted this update on January 1, 2018 resulting in no material impact to our consolidated statements of cash flows. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . This update simplifies the accounting for the income tax consequences of transfers of assets from one unit of a corporation to another unit or subsidiary by eliminating an accounting exception that prevents the recognition of current and deferred income tax consequences for such “intra-entity transfers” until the assets have been sold to an outside party. We adopted this update on January 1, 2018 and recognized the following balance sheet adjustments (in thousands): Balance at December 31, 2017 Adjustment due to ASU No. 2016-16 Balance at January 1, 2018 Assets Prepaid expenses and other current assets $ 39,037 $ (12,604 ) $ 26,433 Deferred tax assets, net 11,559 58,301 69,860 Other assets 75,984 (68,127 ) 7,857 Equity Accumulated deficit $ (39,664 ) $ (22,430 ) $ (62,094 ) In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment . This update removes step 2 of the goodwill impairment test that compares the implied fair value of goodwill with its carrying amount. Instead, an impairment test is performed by comparing the fair value of a reporting unit with its carrying amount. An impairment charge will be recorded by the amount a reporting unit’s carrying amount exceeds its fair value. The update is effective for annual periods after December 15, 2019, including interim periods within those annual reporting periods with early adoption permitted. In March 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business . This update clarifies when a set of assets and activities is a business. We adopted this update on January 1, 2018. The ImThera and TandemLife acquisitions were considered acquisitions of a business. Refer to “ Note 3. Business Combinations ” for a discussion of our acquisitions of ImThera and TandemLife. In March 2017, the FASB issued ASU No. 2017-07, Compensation—Retirement Benefits (Topic 715): Improving the Presentation of Net Periodic Pension Cost and Net Periodic Post Retirement Benefit Cost . This update requires that an employer report the service cost component in the same line item or items as other compensation costs arising from services rendered by the pertinent employees during the period. We adopted this update on January 1, 2018, resulting in an immaterial impact to our consolidated financial statements. The condensed consolidated statements of income for the three and nine months ended September 30, 2017 have been recast for the adoption of this update. In June 2018, the FASB issued ASU No. 2018-07, Compensation—Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting. This update simplifies the accounting for non-employee share-based payment transactions. The amendment specifies that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in a grantor’s own operations by issuing share-based payment awards. The update is effective for annual periods after December 15, 2018, including interim periods within those annual reporting periods with early adoption permitted. We do not expect the adoption of this update to have a material effect on our consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Changes to the Disclosure Requirements for Fair Value Measurement . This update removes, modifies and adds certain disclosure requirements related to fair value measurements. The update is effective for annual periods after December 15, 2019, including interim periods within those annual reporting periods with early adoption permitted. We do not expect the adoption of this update to have a material effect on our consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-14, Compensation—Retirement Benefits—Defined Benefit Plans—General (Subtopic 715-20): Changes to the Disclosure Requirements for Defined Benefit Plans . This update adds and removes certain disclosure requirements related to defined benefit plans. The update is effective for annual periods after December 15, 2020, on a retrospective basis for all periods presented with early adoption permitted. We do not expect the adoption of this update to have a material effect on our consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract. This update clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. This update is effective for annual periods after December 15, 2019, including interim periods within those annual reporting periods with early adoption permitted and should be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. We do not expect the adoption of this update to have a material effect on our consolidated financial statements.

Business Combinations (Tables)

Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2018
Business Combinations [Abstract]
Schedule of Business Acquisitions, by Acquisition	The following table presents the acquisition date fair value of the consideration transferred and the fair value of our interest in ImThera prior to the acquisition (in thousands): Cash $ 78,332 Contingent consideration 112,744 Fair value of our interest in ImThera prior to the acquisition (1) 25,580 Fair value of consideration transferred $ 216,656 (1) The fair value of our previously-held interest in ImThera was determined based on the fair value of total consideration transferred and application of a discount for lack of control. As a result, we recognized a gain of $11.5 million for the fair value in excess of our carrying value of $14.1 million . The gain is reflected as “Gain on acquisitions” on our condensed consolidated statement of income for the nine months ended September 30, 2018 . The following table presents the acquisition date fair value of the consideration transferred (in thousands): Cash $ 203,671 Contingent consideration 40,190 Fair value of consideration transferred $ 243,861
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table presents the preliminary purchase price allocation at fair value for the TandemLife acquisition (in thousands): Initial Purchase Price Allocation Measurement Period Adjustments (1) Adjusted Purchase Price Allocation In-process research and development (2) (3) $ 110,977 $ (3,474 ) $ 107,503 Trade names (2) 11,539 11,539 Developed technology (2) 6,387 6,387 Goodwill 118,917 2,771 121,688 Inventory 10,296 (140 ) 10,156 Other assets and liabilities, net 3,632 3,632 Deferred income tax liabilities, net (4) (17,887 ) 843 (17,044 ) Net assets acquired $ 243,861 $ — $ 243,861 (1) During the third quarter of 2018, measurement period adjustments were recorded based upon new information regarding future estimates of R&D expenses that existed as of the acquisition date. (2) The amounts are included in “Intangible assets, net” in the condensed consolidated balance sheet at September 30, 2018 . Trade names and developed technology are amortized over remaining useful lives of 15 and 2 years, respectively. (3) The fair value of in-process research and development ("IPR&D") was determined using the income approach, which is a valuation technique that provides a fair value estimate based on the market participant expectations of cash flows the asset would generate. The cash flows were discounted commensurate with the level of risk associated with the asset. The discount rates were developed after assigning a probability of success to achieving the projected cash flows based on the current stage of development, inherent uncertainty in reaching certain regulatory milestones and risks associated with commercialization of the product. (4) The amounts include The following table presents the purchase price allocation at fair value for the ImThera acquisition including certain measurement period adjustments (in thousands): Initial Purchase Price Allocation Measurement Period Adjustments (1) Adjusted Purchase Price Allocation In-process research and development (2) $ 151,605 $ 10,677 $ 162,282 Developed technology 5,661 (5,661 ) — Goodwill 87,063 (4,467 ) 82,596 Deferred income tax liabilities, net (3) (27,980 ) (1,278 ) (29,258 ) Other assets and liabilities, net 836 200 1,036 Net assets acquired $ 217,185 $ (529 ) $ 216,656 (1) During the second quarter of 2018, measurement period adjustments were recorded based upon new information obtained about facts and circumstances that existed as of the acquisition date. (2) The fair value of in-process research and development ("IPR&D") was determined using the income approach, which is a valuation technique that provides a fair value estimate based on the market participant expectations of cash flows the asset would generate. The cash flows were discounted commensurate with the level of risk associated with the asset. The discount rates were developed after assigning a probability of success to achieving the projected cash flows based on the current stage of development, inherent uncertainty in reaching certain regulatory milestones and risks associated with commercialization of the product. The IPR&D amount is included in “Intangible assets, net” in the condensed consolidated balance sheet at September 30, 2018 . (3)
Schedule of Business Acquisitions by Acquisition, Contingent Consideration	The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs (in thousands): TandemLife Acquisition Fair value at April 4, 2018 Valuation Technique Unobservable Input Ranges Regulatory milestone-based payments $ 40,190 Discounted cash flow Discount rate 4.2% - 4.8% Probability of payments 75% - 95% Projected payment years 2019 - 2020 The ImThera business combination involved contingent consideration arrangements composed of potential cash payments upon the achievement of a certain regulatory milestone and a sales-based earnout associated with sales of products covered by the purchase agreement. The sales-based earnout was valued using projected sales from our internal strategic plan. Both arrangements are Level 3 fair value measurements and include the following significant unobservable inputs (in thousands): ImThera Acquisition Fair value at January 16, 2018 Valuation Technique Unobservable Input Ranges Regulatory milestone-based payment $ 50,429 Discounted cash flow Discount rate 4.3% - 4.7% Probability of payment 85% - 95% Projected payment years 2020 - 2021 Sales-based earnout 62,315 Monte Carlo simulation Risk-adjusted discount rate 11.5% Credit risk discount rate 4.7% - 5.8% Revenue volatility 29.3% Probability of payment 85% - 95% Projected years of earnout 2020 - 2025 $ 112,744

Discontinued Operations (Tables

Discontinued Operations (Tables)	9 Months Ended
	Sep. 30, 2018
Discontinued Operations and Disposal Groups [Abstract]
Components of discontinued operations	The following table represents assets and liabilities of CRM presented as assets and liabilities of discontinued operations in the condensed consolidated balance sheet: December 31, 2017 Accounts receivable, net $ 64,684 Inventories 54,097 Prepaid taxes 14,725 Prepaid and other assets 3,498 Property, plant and equipment, net 12,104 Deferred tax assets, net 2,517 Investments 6,098 Intangible assets, net 92,966 Assets of discontinued operations $ 250,689 Accounts payable 26,501 Accrued liabilities and other 7,669 Taxes payable 5,084 Accrued employee compensation and benefits 30,753 Deferred income taxes liability 8,068 Liabilities of discontinued operations $ 78,075 The following table represents the financial results of CRM presented as net (loss) income from discontinued operations in the condensed consolidated statements of income: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 (1) 2017 Revenues $ — $ 58,411 $ 77,366 $ 182,235 Cost of sales — 20,493 27,306 66,778 Gross profit — 37,918 50,060 115,457 Selling, general and administrative expenses 543 24,000 43,441 74,997 Research and development — 8,502 16,577 26,879 Merger and integration expenses — 3 — 35 Restructuring expenses — (391 ) 651 (1,750 ) Amortization of intangibles — 3,810 — 10,829 Revaluation gain on assets and liabilities held for sale — — (1,213 ) — Loss on sale of CRM — — 214 — Total operating expenses 543 35,924 59,670 110,990 Operating (loss) income from discontinued operations (543 ) 1,994 (9,610 ) 4,467 Foreign exchange and other gains (losses) — 12 102 (160 ) (Loss) income from discontinued operations, before tax (543 ) 2,006 (9,508 ) 4,307 Income tax expense (benefit) 361 8 (804 ) 62 Losses from equity method investments — (1,183 ) (1,211 ) (3,567 ) Net (loss) income from discontinued operations $ (904 ) $ 815 $ (9,915 ) $ 678 (1) CRM financial results for the nine months ended September 30, 2018 include operating activities through the close of the sale on April 30, 2018.

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2018
Restructuring and Related Activities [Abstract]
Schedule of Restructuring Expense by Reportable Segment	The following table presents restructuring expense by reportable segment (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Cardiovascular (1) $ 354 $ 441 $ 2,093 $ 6,944 Neuromodulation 17 (32 ) 34 407 Other 65 774 666 6,459 Restructuring expense from continuing operations $ 436 $ 1,183 $ 2,793 $ 13,810 (1) Cardiovascular restructuring expense for the nine months ended September 30, 2017 included building and equipment impairment and additional costs of $5.1 million related to the Suzhou, China facility exit plan.

Product Remediation Liability (

Product Remediation Liability (Tables)	9 Months Ended
	Sep. 30, 2018
Environmental Remediation Obligations [Abstract]
Product Liability Contingencies	Changes in the carrying amount of the product remediation liability are as follows (in thousands): Balance at December 31, 2017 $ 27,546 Remediation activity (9,442 ) Effect of changes in foreign currency exchange rates (157 ) Balance at September 30, 2018 (1) $ 17,947 (1) At September 30, 2018 , the product remediation liability balance is included within ‘Accrued liabilities and other’ and ‘Other long-term liabilities’ in the condensed consolidated balance sheet.

Investments (Tables)

Investments (Tables)	9 Months Ended
	Sep. 30, 2018
Investments [Abstract]
Schedule of Cost Method Investments	These equity positions in privately-held companies are included in “Investments” in the condensed consolidated balance sheets (in thousands): September 30, 2018 December 31, 2017 Respicardia Inc. (1) $ 17,706 $ 17,422 Ceribell, Inc. (2) 3,000 — ImThera Medical, Inc. (3) — 12,900 Rainbow Medical Ltd. (4) 1,134 1,172 MD Start II (5) 1,158 1,199 Highlife S.A.S. (6) 1,098 — Other 17 17 $ 24,113 $ 32,710 (1) Respicardia Inc. (“Respicardia”) is a privately funded U.S. company developing an implantable device designed to restore a more natural breathing pattern during sleep in patients with central sleep apnea by transvenously stimulating the phrenic nerve. We have a loan outstanding to Respicardia with a carrying amount of $0.6 million , as of September 30, 2018 , which is included in “Prepaid expenses and other current assets” in the condensed consolidated balance sheet. (2) On September 7, 2018, we acquired 1,007,319 shares of Series B Preferred Stock of Ceribell, Inc. (“Ceribell”). Ceribell is focused on utilizing electroencephalography to improve the diagnosis and treatment of patients at risk for seizures. (3) On January 16, 2018, we acquired the remaining outstanding interests in ImThera. Refer to “ Note 3. Business Combinations .” (4) Rainbow Medical Ltd. is a private Israeli venture capital company that seeds and grows companies developing medical devices in a diverse range of medical fields. (5) MD Start II is a private venture capital collaboration for the development of medical device technology in Europe. (6) Due to an additional investment by a third party during the nine months ended September 30, 2018 , our equity interest in Highlife S.A.S. (“Highlife”) decreased to 17.5% from 24.6% . We determined that we no longer had significant influence over Highlife and, as a result, we began to measure Highlife at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or similar investment of the same issuer. At December 31, 2017 , we accounted for Highlife under the equity method and the carrying value was $1.8 million .

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value Measurements on a Recurring Basis	The following table provides information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of September 30, 2018 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - freestanding instruments (foreign currency exchange rate “FX”) $ 3,309 $ — $ 3,309 $ — $ 3,309 $ — $ 3,309 $ — Liabilities: Derivative liabilities - designated as cash flow hedges FX $ 1,084 $ — $ 1,084 $ — Derivative liabilities - designated as cash flow hedges (interest rate swaps) 996 — 996 — Derivative liabilities - freestanding instruments FX 224 — 224 — Contingent consideration (1) 183,012 — — 183,012 $ 185,316 $ — $ 2,304 $ 183,012 Fair Value as of December 31, 2017 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - freestanding instruments (FX) $ 519 $ — $ 519 $ — $ 519 $ — $ 519 $ — Liabilities: Derivative liabilities - designated as cash flow hedges (FX) $ 460 $ — $ 460 $ — Derivative liabilities - designated as cash flow hedges (interest rate swaps) 1,585 — 1,585 — Contingent consideration (1) 33,973 — — 33,973 $ 36,018 $ — $ 2,045 $ 33,973 (1) The contingent consideration liability represents contingent payments related to five completed acquisitions: Cellplex PTY Ltd., Inversiones Drilltex SAS, Caisson, ImThera and TandemLife.
Reconciliation of Beginning and Ending Balances of Contingent Consideration	The following table provides a reconciliation of the beginning and ending balance of the contingent consideration liability (in thousands): Total contingent consideration liability at December 31, 2017 $ 33,973 Purchase price - ImThera contingent consideration 112,744 Purchase price - TandemLife contingent consideration 40,190 Payments (2,661 ) Changes in fair value (1) (1,258 ) Effect of changes in foreign currency exchange rates 24 Total contingent consideration liability at September 30, 2018 183,012 Less current portion of contingent consideration liability at September 30, 2018 18,402 Long-term portion of contingent consideration liability at September 30, 2018 $ 164,610 (1) Includes a decrease of $3.8 million and $2.3 million recorded to cost of sales and R&D expenses, respectively, recognized during the second quarter of 2018 due to the delay in the timing of anticipated regulatory approval for ImThera. See “ Note 3. Business Combinations ” for additional discussion.

Financing Arrangements (Tables)

Financing Arrangements (Tables)	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Schedule of Long-term Debt	The outstanding principal amount of long-term debt (in thousands, except interest rates): September 30, 2018 December 31, 2017 Maturity Interest Rate 2017 European Investment Bank (1) $ 60,000 $ — June 2026 3.35 % 2014 European Investment Bank (2) 57,903 69,893 June 2021 0.97 % Mediocredito Italiano (3) 8,383 9,118 December 2023 0.50% - 3.10% Banca del Mezzogiorno (4) 4,118 5,499 December 2019 0.50% - 3.15% Region Wallonne 752 845 December 2023 and June 2033 0.00% - 2.45% Mediocredito Italiano - mortgages and other 512 997 September 2021 and September 2026 0.80% - 1.30% Bpifrance (ex-Oséo) — 1,450 — 2.58 % Total long-term facilities 131,668 87,802 Less current portion of long-term debt 23,578 25,844 Total long-term debt $ 108,090 $ 61,958 (1) The 2017 European Investment Bank (“2017 EIB”) loan was obtained to support certain product development projects. The interest rate for the 2017 EIB loan is reset by the lender each principal payment date based on LIBOR. Interest payments are paid quarterly and principal payments are paid semi-annually. On July 30, 2018, we borrowed $60.0 million under the 2017 EIB loan. (2) The 2014 European Investment Bank (“2014 EIB”) loan was obtained in July 2014 to support certain product development projects. The interest rate for the 2014 EIB loan is reset by the lender each quarter based on the Euribor. Interest payments are paid quarterly and principal payments are paid semi-annually. (3) We obtained the Mediocredito Italiano Bank loan in July 2016 as part of the Fondo Innovazione Teconologica program implemented by the Italian Ministry of Education. (4) The Banca del Mezzogiorno loan was obtained in January 2015 to support R&D projects as a part of the Large Strategic Project program of the Italian Ministry of Education.

Derivatives and Risk Manageme_2

Derivatives and Risk Management (Tables)	9 Months Ended
	Sep. 30, 2018
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Notional Amounts of Derivative Contracts Designated Cash Flow Hedges	Notional amounts of open derivative contracts designated as cash flow hedges (in thousands): Description of Derivative Contract September 30, 2018 December 31, 2017 FX derivative contracts to be exchanged for British Pounds $ 8,256 $ 16,847 FX derivative contracts to be exchanged for Japanese Yen 13,712 32,302 FX derivative contracts to be exchanged for Canadian Dollars 14,053 16,494 FX derivative contracts to be exchanged for Euros 28,657 — Interest rate swap contracts 46,322 55,965 $ 111,000 $ 121,608
Unrealized Gain (Loss) in AOCI	After-tax net loss associated with derivatives designated as cash flow hedges recorded in the ending balance of AOCI and the amount expected to be reclassified to earnings in the next twelve months (in thousands): Description of Derivative Contract After-tax net loss in AOCI as of September 30, 2018 Amount Expected to be Reclassified to Earnings in Next 12 Months FX derivative contracts $ (601 ) $ (601 ) Interest rate swap contracts (139 ) (51 ) $ (740 ) $ (652 )
Schedule of Cash Flow Hedges Included in AOCI	Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in Other Comprehensive Income (Loss) (“OCI”) and the amount reclassified to earnings from AOCI (in thousands): Three Months Ended September 30, 2018 2017 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 125 $ 2,511 $ (2,537 ) $ (1,623 ) FX derivative contracts SG&A — (3,007 ) — 269 Interest rate swap contracts Interest expense — (72 ) — 797 $ 125 $ (568 ) $ (2,537 ) $ (557 ) Nine Months Ended September 30, 2018 2017 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 314 $ 1,999 $ (10,124 ) $ (6,833 ) FX derivative contracts SG&A — (1,833 ) — 1,623 Interest rate swap contracts Interest expense — (89 ) — 1,009 $ 314 $ 77 $ (10,124 ) $ (4,201 )
Schedule of Fair Value of Derivative Instruments in Statement of Financial Position	The following tables present the fair value on a gross basis, and the location of, derivative contracts reported in the condensed consolidated balance sheets (in thousands): September 30, 2018 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Interest rate swap contracts Prepaid expenses and other current assets $ — Accrued liabilities $ 487 Interest rate swap contracts Other assets — Other long-term liabilities 509 FX derivative contracts Prepaid expenses and other current assets — Accrued liabilities 1,084 Total derivatives designated as hedging instruments — 2,080 Derivatives Not Designated as Hedging Instruments FX derivative contracts Prepaid expenses and other current assets 3,309 Accrued liabilities 224 Total derivatives not designated as hedging instruments 3,309 224 Total derivatives $ 3,309 $ 2,304 December 31, 2017 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Interest rate swap contracts Prepaid expenses and other current assets $ — Accrued liabilities $ 834 Interest rate swap contracts Other assets — Other long-term liabilities 751 FX derivative contracts Prepaid expenses and other current assets — Accrued liabilities 460 Total derivatives designated as hedging instruments — 2,045 Derivatives Not Designated as Hedging Instruments FX derivative contracts Prepaid expenses and other current assets 519 Accrued liabilities — Total derivatives not designated as hedging instruments 519 — Total derivatives $ 519 $ 2,045 (1) For the classification of inputs used to evaluate the fair value of our derivatives, refer to “ Note 8. Fair Value Measurements .”

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2018
Stockholders' Equity Note [Abstract]
Schedule of Accumulated Other Comprehensive Income (Loss)	The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income for the nine months ended September 30, 2018 and September 30, 2017 (in thousands): Change in Unrealized Gain (Loss) on Derivatives Foreign Currency Translation Adjustments Gain (Loss) ( 1) Total As of December 31, 2017 $ (919 ) $ 46,232 $ 45,313 Other comprehensive income (loss) before reclassifications, before tax 314 (36,727 ) (36,413 ) Tax expense (75 ) — (75 ) Other comprehensive income (loss) before reclassifications, net of tax 239 (36,727 ) (36,488 ) Reclassification of gain from accumulated other comprehensive income, before tax (77 ) (9,011 ) (2) (9,088 ) Reclassification of tax expense 18 — 18 Reclassification of gain from accumulated other comprehensive income, after tax (59 ) (9,011 ) (9,070 ) Net current-period other comprehensive income (loss), net of tax 180 (45,738 ) (45,558 ) As of September 30, 2018 $ (739 ) $ 494 $ (245 ) As of December 31, 2016 $ 3,619 $ (72,106 ) $ (68,487 ) Other comprehensive (loss) income before reclassifications, before tax (10,124 ) 111,123 100,999 Tax benefit 2,784 — 2,784 Other comprehensive (loss) income before reclassifications, net of tax (7,340 ) 111,123 103,783 Reclassification of loss from accumulated other comprehensive income, before tax 4,201 — 4,201 Reclassification of tax benefit (1,028 ) — (1,028 ) Reclassification of loss from accumulated other comprehensive income, after tax 3,173 — 3,173 Net current-period other comprehensive (loss) income, net of tax (4,167 ) 111,123 106,956 As of September 30, 2017 $ (548 ) $ 39,017 $ 38,469 (1) Taxes are not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned. (2) Cumulative foreign currency translation adjustments eliminated upon the sale of CRM.

Stock-Based Incentive Plan (Tab

Stock-Based Incentive Plan (Tables)	9 Months Ended
	Sep. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-based Compensation, Stock Options, Activity	Stock-based incentive plans compensation expense (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Service-based stock appreciation rights ("SARs") $ 2,491 $ 2,433 $ 6,514 $ 5,764 Service-based restricted stock units ("RSUs") 3,368 2,135 8,158 6,453 Market performance-based restricted stock units 509 289 1,814 463 Operating performance-based restricted stock units 909 611 2,941 1,018 Total stock-based compensation expense $ 7,277 $ 5,468 $ 19,427 $ 13,698 Stock-based compensation agreements issued during the nine months ended September 30, 2018 , representing potential shares and their weighted average grant date fair values by type follows (shares in thousands, fair value in dollars): Nine Months Ended September 30, 2018 Shares Weighted Average Grant Date Fair Value Service-based SARs 648 $ 28.13 Service-based RSUs 255 $ 95.61 Market performance-based RSUs 43 $ 101.50 Operating performance-based RSUs 43 $ 89.74

Net Income (Loss) Per Share (Ta

Net Income (Loss) Per Share (Tables)	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Schedule of Basic and Diluted Net Income Per Share	Reconciliation of the shares used in the basic and diluted earnings per share computations for the three and nine months ended September 30, 2018 and September 30, 2017 are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Basic weighted average shares outstanding 48,637 48,181 48,484 48,130 Add effects of share-based compensation instruments (1) — 353 943 209 Diluted weighted average shares outstanding 48,637 48,534 49,427 48,339 (1) Excluded from the computation of diluted earnings per share for the three months ended September 30, 2018 were stock options, SARs and restricted share units totaling 2.8 million , because to include them would be anti-dilutive under the treasury stock method due to the net loss. Excluded from the computation of diluted earnings per share for the nine months ended September 30, 2018 were stock options, SARs and restricted share units totaling 0.5 million because to include them would be anti-dilutive under the treasury stock method. Excluded from the computation of diluted earnings per share for the three and nine months ended September 30, 2017 were stock options, SARs and restricted share units totaling 1.6 million , because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Inform_2

Geographic and Segment Information (Tables)	9 Months Ended
	Sep. 30, 2018
Segment Reporting [Abstract]
Revenue from External Customers by Geographic Areas	The table below presents net sales by operating segment and geographic region (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Cardiopulmonary United States $ 40,396 $ 38,379 $ 120,980 $ 110,274 Europe 32,186 30,520 104,972 95,088 Rest of world 55,358 54,665 163,757 149,645 127,940 123,564 389,709 355,007 Heart Valves United States 6,145 6,612 18,828 18,886 Europe 9,421 9,909 33,400 30,940 Rest of world 16,980 19,737 45,162 52,779 32,546 36,258 97,390 102,605 Advanced Circulatory Support United States 5,947 — 11,415 — Europe 38 — 391 — Rest of world 90 — 284 — 6,075 — 12,090 — Cardiovascular United States 52,488 44,991 151,223 129,160 Europe 41,645 40,429 138,763 126,028 Rest of world 72,428 74,402 209,203 202,424 166,561 159,822 499,189 457,612 Neuromodulation United States 87,194 76,286 254,581 231,350 Europe 9,497 8,057 31,731 25,500 Rest of world 8,252 6,673 23,128 18,340 104,943 91,016 309,440 275,190 Other 578 415 1,349 1,119 Totals United States 139,682 121,277 405,804 360,510 Europe (1) 51,142 48,486 170,494 151,528 Rest of world 81,258 81,490 233,680 221,883 Total (2) $ 272,082 $ 251,253 $ 809,978 $ 733,921 (1) Europe sales include those countries in which we have a direct sales presence, whereas European countries in which we sell through distributors are included in Rest of world. (2) No single customer represented over 10% of our consolidated net sales. No country’s net sales exceeded 10% of our consolidated sales except for the U.S.
Schedule of Segment Reporting Information, by Segment	Operating income by segment is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Operating Income from Continuing Operations 2018 2017 2018 2017 Cardiovascular $ 9,783 $ 23,788 $ 36,378 $ 63,594 Neuromodulation 36,432 46,524 132,377 138,544 Other (29,420 ) (28,557 ) (89,479 ) (78,460 ) Total reportable segment income from continuing operations 16,795 41,755 79,276 123,678 Merger and integration expenses 12,659 2,010 20,028 7,708 Restructuring expenses 436 1,183 2,793 13,810 Amortization of intangibles 9,457 8,540 28,075 24,616 Operating (loss) income from continuing operations $ (5,757 ) $ 30,022 $ 28,380 $ 77,544 Assets by reportable segment (in thousands): Assets September 30, 2018 December 31, 2017 Cardiovascular $ 1,548,866 $ 1,386,032 Neuromodulation 762,375 532,894 Other 299,439 334,276 Discontinued operations — 250,689 Total assets $ 2,610,680 $ 2,503,891 Capital expenditures by segment (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Capital expenditures 2018 2017 2018 2017 Cardiovascular $ 8,032 $ 5,541 $ 15,757 $ 13,292 Neuromodulation 512 370 1,359 2,348 Other 4,359 1,633 7,058 4,021 Discontinued operations — 1,537 925 4,343 Total $ 12,903 $ 9,081 $ 25,099 $ 24,004
Schedule of Goodwill	The changes in the carrying amount of goodwill by reportable segment for the nine months ended September 30, 2018 were as follows (in thousands): Neuromodulation Cardiovascular Other Total December 31, 2017 $ 315,943 $ 425,882 $ 42,417 $ 784,242 Goodwill as a result of acquisitions (1) 82,596 121,688 — 204,284 Foreign currency adjustments — (19,249 ) — (19,249 ) September 30, 2018 $ 398,539 $ 528,321 $ 42,417 $ 969,277 (1) Goodwill recognized as a result of the ImThera and TandemLife acquisitions. Refer to “ Note 3. Business Combinations .”
Long-lived Assets by Geographic Areas	Property, plant and equipment, net by geography are as follows (in thousands): PP&E September 30, 2018 December 31, 2017 United States $ 65,776 $ 62,154 Europe 112,092 119,133 Rest of world 10,592 11,072 Total $ 188,460 $ 192,359

Supplemental Financial Inform_2

Supplemental Financial Information (Tables)	9 Months Ended
	Sep. 30, 2018
Balance Sheet Related Disclosures [Abstract]
Inventories	Inventories consisted of the following (in thousands): September 30, 2018 December 31, 2017 Raw materials $ 37,839 $ 39,810 Work-in-process 20,321 18,206 Finished goods 94,896 86,454 $ 153,056 $ 144,470
Accrued Liabilities	Accrued liabilities and other consisted of the following (in thousands): September 30, 2018 December 31, 2017 Contingent consideration (1) $ 18,402 $ — Product remediation (2) 15,509 16,811 CRM purchase price adjustment payable to MicroPort Scientific Corporation 14,891 — Legal and administrative costs 13,041 6,082 Other amounts payable to MicroPort Scientific Corporation 11,419 — Deferred consideration - Caisson — 14,300 Other accrued expenses 45,471 41,749 $ 118,733 $ 78,942 (1) Refer to “ Note 8. Fair Value Measurements ” (2) Refer to “ Note 6. Product Remediation Liability ”

New Accounting Pronouncements (

New Accounting Pronouncements (Tables)	9 Months Ended
	Sep. 30, 2018
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
Schedule of New Accounting Pronouncements and Changes in Accounting Principles	We adopted this update on January 1, 2018 and recognized the following balance sheet adjustments (in thousands): Balance at December 31, 2017 Adjustment due to ASU No. 2016-16 Balance at January 1, 2018 Assets Prepaid expenses and other current assets $ 39,037 $ (12,604 ) $ 26,433 Deferred tax assets, net 11,559 58,301 69,860 Other assets 75,984 (68,127 ) 7,857 Equity Accumulated deficit $ (39,664 ) $ (22,430 ) $ (62,094 )

Unaudited Condensed Consolida_3

Unaudited Condensed Consolidated Financial Statements (Narrative) (Details) - USD ($) $ in Thousands	Apr. 30, 2018	Sep. 30, 2018	Dec. 31, 2017
Disposal Groups, Including Discontinued Operations [Line Items]
Contingent consideration		$ 164,610	$ 33,973
CRM Business Franchise
Disposal Groups, Including Discontinued Operations [Line Items]
Consideration transferred	$ 195,900
Consideration transferred, cash	$ 9,200

Revenue Recognition (Details)

Revenue Recognition (Details) $ in Millions	9 Months Ended
	Sep. 30, 2018USD ($)Product_Line	Dec. 31, 2017USD ($)
Accrued liabilities and other
Disaggregation of Revenue [Line Items]
Contract liability | $	$ 5.2	$ 3.8
Cardiovascular
Disaggregation of Revenue [Line Items]
Number of product lines | Product_Line	3

Business Combinations - Narrati

Business Combinations - Narrative (Details) - USD ($) $ in Thousands	Apr. 04, 2018	Jan. 16, 2018	May 02, 2017	Sep. 30, 2018	Jun. 30, 2018	Sep. 30, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Contingent consideration				$ 164,610		$ 164,610	$ 33,973
Caisson Interventional LLC
Business Acquisition [Line Items]
Percentage of voting interests acquired			51.00%
Debt forgiveness			$ 6,300
Cash			18,000		$ 14,400
Contingent consideration					$ 39,600
ImThera Medical, Inc.
Business Acquisition [Line Items]
Percentage of voting interests acquired		86.00%
Fair value of consideration transferred		$ 216,656
Cash		78,300
Contingent consideration		112,744
Revenue				100		300
Operating loss				(2,900)		(6,500)
TandemLife
Business Acquisition [Line Items]
Fair value of consideration transferred	$ 243,861
Cash	203,671
Contingent consideration	50,000
Revenue				6,100		12,100
Operating loss				(6,000)		(12,100)
Upfront costs	204,000
SG&A | ImThera Medical, Inc.
Business Acquisition [Line Items]
Acquisition-related expense				100		400
SG&A | TandemLife
Business Acquisition [Line Items]
Acquisition-related expense				$ 400		$ 2,200
Maximum | Caisson Interventional LLC
Business Acquisition [Line Items]
Fair value of consideration transferred			$ 72,000
Maximum | ImThera Medical, Inc.
Business Acquisition [Line Items]
Fair value of consideration transferred		$ 225,000
Maximum | TandemLife
Business Acquisition [Line Items]
Fair value of consideration transferred	$ 254,000

Business Combinations - Purchas

Business Combinations - Purchase Price Composition (Details) - USD ($) $ in Thousands	Apr. 04, 2018	Jan. 16, 2018	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Business Acquisition [Line Items]
Contingent consideration			$ 18,402		$ 18,402		$ 0
Gain from acquisition			$ 0	$ 0	11,484	$ 39,428
ImThera Medical, Inc.
Business Acquisition [Line Items]
Cash		$ 78,300
Contingent consideration		112,744
Fair value of our interest prior to the acquisition		25,580
Fair value of consideration transferred		$ 216,656
Gain from acquisition					11,500
Fair value in excess of carrying value adjustment					$ 14,100
TandemLife
Business Acquisition [Line Items]
Cash	$ 203,671
Contingent consideration	40,190
Fair value of consideration transferred	$ 243,861

Business Combinations - Prelimi

Business Combinations - Preliminary Purchase Price Allocation (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Apr. 04, 2018	Jan. 16, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill	$ 969,277			$ 784,242
ImThera Medical, Inc.
Business Acquisition [Line Items]
Goodwill	82,596		$ 87,063
Goodwill, adjustment	(4,467)
Deferred income tax liabilities, net	(29,258)		(27,980)
Deferred income taxes, net, adjustment	(1,278)
Other assets and liabilities, net	1,036		836
Other assets and liabilities, net , adjustment	200
Net assets acquired	216,656		217,185
Net assets acquired, adjustment	(529)
TandemLife
Business Acquisition [Line Items]
Goodwill	121,688	$ 118,917
Goodwill, adjustment	2,771
Inventory	10,156	10,296
Inventory, adjustment	(140)
Deferred income tax liabilities, net	(17,044)	(17,887)
Deferred income taxes, net, adjustment	(843)
Other assets and liabilities, net	3,632	3,632
Net assets acquired	243,861	243,861
Net assets acquired, adjustment	$ 0
Useful life	2 years
In Process Research and Development | ImThera Medical, Inc.
Business Acquisition [Line Items]
Intangible asset	$ 162,282		151,605
Intangible asset, adjustment	10,677
In Process Research and Development | TandemLife
Business Acquisition [Line Items]
Intangible asset	107,503	110,977
Intangible asset, adjustment	(3,474)
Trade Names | TandemLife
Business Acquisition [Line Items]
Intangible asset	$ 11,539	11,539
Useful life	15 years
Developed Technology | ImThera Medical, Inc.
Business Acquisition [Line Items]
Intangible asset	$ 0		$ 5,661
Intangible asset, adjustment	(5,661)
Developed Technology | TandemLife
Business Acquisition [Line Items]
Intangible asset	$ 6,387	$ 6,387

Business Combinations - Conting

Business Combinations - Contingent Consideration (Details) - USD ($) $ in Thousands	Apr. 04, 2018	Jan. 16, 2018	Sep. 30, 2018	Dec. 31, 2017
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration			$ 164,610	$ 33,973
ImThera Medical, Inc.
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration		$ 112,744
ImThera Medical, Inc. | Discounted Cash Flow
Business Acquisition, Contingent Consideration [Line Items]
Regulatory milestone-based payment		$ 50,429
ImThera Medical, Inc. | Discounted Cash Flow | Minimum
Business Acquisition, Contingent Consideration [Line Items]
Discount rate		4.30%
Probability of payment		85.00%
ImThera Medical, Inc. | Discounted Cash Flow | Maximum
Business Acquisition, Contingent Consideration [Line Items]
Discount rate		4.70%
Probability of payment		95.00%
ImThera Medical, Inc. | Monte Carlo Simulation
Business Acquisition, Contingent Consideration [Line Items]
Sales-based earnout		$ 62,315
Risk adjusted discount rate		11.50%
Revenue volatility		29.30%
ImThera Medical, Inc. | Monte Carlo Simulation | Minimum
Business Acquisition, Contingent Consideration [Line Items]
Probability of payment		85.00%
Credit risk rate		4.70%
ImThera Medical, Inc. | Monte Carlo Simulation | Maximum
Business Acquisition, Contingent Consideration [Line Items]
Probability of payment		95.00%
Credit risk rate		5.80%
TandemLife
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 50,000
TandemLife | Discounted Cash Flow
Business Acquisition, Contingent Consideration [Line Items]
Regulatory milestone-based payment	$ 40,190
TandemLife | Discounted Cash Flow | Minimum
Business Acquisition, Contingent Consideration [Line Items]
Discount rate	4.20%
Probability of payment	75.00%
TandemLife | Discounted Cash Flow | Maximum
Business Acquisition, Contingent Consideration [Line Items]
Discount rate	4.80%
Probability of payment	95.00%

Discontinued Operations (Detail

Discontinued Operations (Details) - USD ($) $ in Millions	Apr. 30, 2018	Sep. 30, 2018	Sep. 30, 2018	Sep. 30, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Stock-based compensation			$ 2.1	$ 0.6
CRM Business Franchise
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration transferred	$ 195.9
Consideration transferred, cash	$ 9.2
Transition services		$ 1.1	2
Capital expenditure			$ 0.9	4.3
Depreciation and amortization				$ 15.4

Discontinued Operations (Assets

Discontinued Operations (Assets And Liabilities Classified As Held For Sale) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Assets of discontinued operations	$ 0	$ 250,689
Liabilities of discontinued operations	$ 0	78,075
CRM Business Franchise | Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Accounts receivable, net		64,684
Inventories		54,097
Prepaid taxes		14,725
Prepaid and other assets		3,498
Property, plant and equipment, net		12,104
Deferred tax assets, net		2,517
Investments		6,098
Intangible assets, net		92,966
Assets of discontinued operations		250,689
Accounts payable		26,501
Accrued liabilities and other		7,669
Taxes payable		5,084
Accrued employee compensation and benefits		30,753
Deferred income taxes liability		8,068
Liabilities of discontinued operations		$ 78,075

Discontinued Operations (Operat

Discontinued Operations (Operating Gains And Losses) (Details) - CRM Business Franchise - Discontinued Operations, Held-for-sale - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues	$ 0	$ 58,411	$ 77,366	$ 182,235
Cost of sales	0	20,493	27,306	66,778
Gross profit	0	37,918	50,060	115,457
Selling, general and administrative expenses	543	24,000	43,441	74,997
Research and development	0	8,502	16,577	26,879
Merger and integration expenses	0	3	0	35
Restructuring expenses	0	(391)	651	(1,750)
Amortization of intangibles	0	3,810	0	10,829
Revaluation gain on assets and liabilities held for sale	0	0	(1,213)	0
Loss on sale of CRM	0	0	214	0
Total operating expenses	543	35,924	59,670	110,990
Operating (loss) income from discontinued operations	(543)	1,994	(9,610)	4,467
Foreign exchange and other gains (losses)	0	12	102	(160)
(Loss) income from discontinued operations, before tax	(543)	2,006	(9,508)	4,307
Income tax expense (benefit)	361	8	(804)	62
Losses from equity method investments	0	(1,183)	(1,211)	(3,567)
Net income (loss) from discontinued operations	$ (904)	$ 815	$ (9,915)	$ 678

Restructuring (Narrative) (Deta

Restructuring (Narrative) (Details) - Suzhou Industrial Park Facility - USD ($) $ in Millions	1 Months Ended	9 Months Ended
	Apr. 30, 2018	Sep. 30, 2017
Restructuring Cost and Reserve [Line Items]
Employee severance		$ (0.5)
Proceeds from sale of facility	$ 13.3
Building and Equipment
Restructuring Cost and Reserve [Line Items]
Asset Impairment Charges		$ (4.6)

Restructuring (Restructuring Ex

Restructuring (Restructuring Expense by Segment) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Restructuring Cost and Reserve [Line Items]
Charges	$ 436	$ 1,183	$ 2,793	$ 13,810
Operating Segments | Cardiovascular
Restructuring Cost and Reserve [Line Items]
Charges	354	441	2,093	6,944
Operating Segments | Neuromodulation
Restructuring Cost and Reserve [Line Items]
Charges	17	(32)	34	407
Other
Restructuring Cost and Reserve [Line Items]
Charges	$ 65	$ 774	$ 666	6,459
Building and Equipment | Suzhou Industrial Park Facility
Restructuring Cost and Reserve [Line Items]
Restructuring charges, net				$ 5,100

Product Remediation Liability_2

Product Remediation Liability (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Environmental Remediation Obligations [Abstract]
Environmental remediation expense	$ 3,400	$ 1,600	$ 8,700	$ 2,600
Accrual for Environmental Loss Contingencies [Roll Forward]
Product remediation accrual, beginning balance			27,546
Remediation activity			(9,442)
Effect of changes in foreign currency exchange rates			(157)
Product remediation accrual, ending balance	$ 17,947		$ 17,947

Investments (Details)

Investments (Details) - USD ($) $ in Thousands	Sep. 07, 2018	Sep. 30, 2018	Sep. 29, 2018	Dec. 31, 2017
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		$ 24,113		$ 32,710
Ownership percentage (percent)		24.60%
Cost Method Investee | Respicardia | Prepaid expenses and other current assets
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Outstanding loans		$ 600
Respicardia
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		17,706		17,422
Ceribell, Inc.
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		3,000		0
ImThera Medical, Inc.
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		0		12,900
Rainbow Medical Ltd.
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		1,134		1,172
MD Start II
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		1,158		1,199
Highlife S.A.S.
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		1,098		0
Ownership percentage (percent)			17.50%
Equity method investments				1,800
Other
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Investments		$ 17		$ 17
Series B Preferred Stock | Ceribell, Inc.
Schedule of Cost-method Investments [Line Items] (Deprecated 2018-01-31)
Treasury Stock, shares, acquired	1,007,319

Fair Value Measurements (Assets

Fair Value Measurements (Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)acquisition	Dec. 31, 2017USD ($)
Liabilities:
Number of businesses acquired | acquisition	5
Level 3
Liabilities:
Contingent consideration		$ 33,973
Fair Value, Measurements, Recurring
Assets:
Total assets	$ 3,309	519
Liabilities:
Contingent consideration	183,012	33,973
Total liabilities	185,316	36,018
Fair Value, Measurements, Recurring | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Liabilities:
Derivative liabilities	1,084	460
Fair Value, Measurements, Recurring | Derivatives Designated as Hedging Instruments | Interest Rate Contract
Liabilities:
Derivative liabilities	996	1,585
Fair Value, Measurements, Recurring | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	3,309	519
Liabilities:
Derivative liabilities	224
Fair Value, Measurements, Recurring | Level 1
Assets:
Total assets	0	0
Liabilities:
Contingent consideration	0	0
Total liabilities	0	0
Fair Value, Measurements, Recurring | Level 1 | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Liabilities:
Derivative liabilities	0	0
Fair Value, Measurements, Recurring | Level 1 | Derivatives Designated as Hedging Instruments | Interest Rate Contract
Liabilities:
Derivative liabilities	0	0
Fair Value, Measurements, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	0	0
Liabilities:
Derivative liabilities	0
Fair Value, Measurements, Recurring | Level 2
Assets:
Total assets	3,309	519
Liabilities:
Contingent consideration	0	0
Total liabilities	2,304	2,045
Fair Value, Measurements, Recurring | Level 2 | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Liabilities:
Derivative liabilities	1,084	460
Fair Value, Measurements, Recurring | Level 2 | Derivatives Designated as Hedging Instruments | Interest Rate Contract
Liabilities:
Derivative liabilities	996	1,585
Fair Value, Measurements, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	3,309	519
Liabilities:
Derivative liabilities	224
Fair Value, Measurements, Recurring | Level 3
Assets:
Total assets	0	0
Liabilities:
Contingent consideration	183,012	33,973
Total liabilities	183,012	33,973
Fair Value, Measurements, Recurring | Level 3 | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Liabilities:
Derivative liabilities	0	0
Fair Value, Measurements, Recurring | Level 3 | Derivatives Designated as Hedging Instruments | Interest Rate Contract
Liabilities:
Derivative liabilities	0	0
Fair Value, Measurements, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	0	$ 0
Liabilities:
Derivative liabilities	$ 0

Fair Value Measurements - Conti

Fair Value Measurements - Contingent Consideration Reconciliation (Details) - Level 3 $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Contingent consideration, start	$ 33,973
Payments	(2,661)
Effect of changes in foreign currency exchange rates	24
Fair value, current liability	18,402
Fair value, non-current liability	164,610
ImThera Medical, Inc.
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Purchase price - contingent consideration	112,744
Changes in fair value	(1,258)
TandemLife
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Purchase price - contingent consideration	40,190
Cost of Sales | TandemLife
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Fair value, timing delay of anticipated regulatory approval\	3,800
Research and Development Expense | TandemLife
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Fair value, timing delay of anticipated regulatory approval\	$ 2,300

Financing Arrangements (Long-Te

Financing Arrangements (Long-Term Debt Outstanding, Revolving Credit and European Investment Bank Financing Agreement) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Total long-term facilities	$ 131,668	$ 87,802
Less current portion of long-term debt	23,578	25,844
Total long-term debt	108,090	61,958
Loans Payable | 2017 European Investment Bank
Debt Instrument [Line Items]
Total long-term facilities	$ 60,000	0
Interest rate (percent)	3.35%
Loans Payable | 2014 European Investment Bank
Debt Instrument [Line Items]
Total long-term facilities	$ 57,903	69,893
Interest rate (percent)	0.97%
Loans Payable | Mediocredito Italiano
Debt Instrument [Line Items]
Total long-term facilities	$ 8,383	9,118
Loans Payable | Mediocredito Italiano | Minimum
Debt Instrument [Line Items]
Interest rate (percent)	0.50%
Loans Payable | Mediocredito Italiano | Maximum
Debt Instrument [Line Items]
Interest rate (percent)	3.10%
Loans Payable | Banca del Mezzogiorno
Debt Instrument [Line Items]
Total long-term facilities	$ 4,118	5,499
Loans Payable | Banca del Mezzogiorno | Minimum
Debt Instrument [Line Items]
Interest rate (percent)	0.50%
Loans Payable | Banca del Mezzogiorno | Maximum
Debt Instrument [Line Items]
Interest rate (percent)	3.15%
Loans Payable | Novalia SA
Debt Instrument [Line Items]
Total long-term facilities	$ 752	845
Loans Payable | Novalia SA | Minimum
Debt Instrument [Line Items]
Interest rate (percent)	0.00%
Loans Payable | Novalia SA | Maximum
Debt Instrument [Line Items]
Interest rate (percent)	2.45%
Loans Payable | Bpifrance
Debt Instrument [Line Items]
Total long-term facilities	$ 0	1,450
Interest rate (percent)	2.58%
Mortgages | Mediocredito Italiano
Debt Instrument [Line Items]
Total long-term facilities	$ 512	$ 997
Mortgages | Mediocredito Italiano | Minimum
Debt Instrument [Line Items]
Interest rate (percent)	0.80%
Mortgages | Mediocredito Italiano | Maximum
Debt Instrument [Line Items]
Interest rate (percent)	1.30%

Financing Arrangements (Details

Financing Arrangements (Details) € in Millions	Jul. 30, 2018USD ($)	Apr. 10, 2018USD ($)	Sep. 30, 2018USD ($)	May 01, 2018EUR (€)	Apr. 09, 2018USD ($)	Apr. 03, 2018USD ($)	Mar. 23, 2018USD ($)	Dec. 31, 2017USD ($)
Revolving Credit Facility
Debt Instrument [Line Items]
Short-term debt			$ 25,400,000					$ 58,200,000
Debt instrument, term		1 year
Minimum | Revolving Credit Facility
Debt Instrument [Line Items]
Interest rate (percent)			0.50%
Debt instrument, term			30 days
Maximum | Revolving Credit Facility
Debt Instrument [Line Items]
Interest rate (percent)			9.30%
Debt instrument, term			180 days
Bridge Loan
Debt Instrument [Line Items]
Finance contract, borrowing base						$ 190,000,000	$ 190,000,000
2017 European Investment Bank
Debt Instrument [Line Items]
Proceeds from loans	$ 60,000,000
Barclays Bank | London Interbank Offered Rate (LIBOR) | Revolving Credit Facility
Debt Instrument [Line Items]
Finance contract, borrowing base		$ 70,000,000			$ 40,000,000
Debt instrument, basis spread on variable rate		0.85%
CRM Business Franchise | European Investment Bank
Debt Instrument [Line Items]
Maximum borrowing capacity, before sale			$ 115,800,000	€ 100
Maximum borrowing capacity, after sale			$ 104,200,000	€ 90

Derivatives and Risk Manageme_3

Derivatives and Risk Management (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Foreign Exchange Contract
Derivative [Line Items]
Loss reclassified from accumulated oci			$ 0.6
Derivatives Not Designated as Hedging Instruments | Foreign Exchange Forward
Derivative [Line Items]
Notional amount	$ 229.3		229.3		$ 231.9
Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract | Foreign exchange and other gains (losses)
Derivative [Line Items]
Gain (loss) on derivative	$ 5.6	$ (0.7)	$ (6)	$ (7.9)

Derivatives and Risk Manageme_4

Derivatives and Risk Management (Derivative Notional Amounts) (Details) - Derivatives Designated as Hedging Instruments - Cash Flow Hedging - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Derivative [Line Items]
Notional amount	$ 111,000	$ 121,608
After-tax, net unrealized losses on derivatives arising during period	(740)
Net amount expected to be reclassified to earnings in the next 12 months	(652)
Foreign Exchange Contract
Derivative [Line Items]
After-tax, net unrealized losses on derivatives arising during period	(601)
Net amount expected to be reclassified to earnings in the next 12 months	(601)
Foreign Exchange Contract | United Kingdom, Pounds
Derivative [Line Items]
Notional amount	8,256	16,847
Foreign Exchange Contract | Japan, Yen
Derivative [Line Items]
Notional amount	13,712	32,302
Foreign Exchange Contract | Canada, Dollars
Derivative [Line Items]
Notional amount	14,053	16,494
Foreign Exchange Contract | Euro Member Countries, Euro
Derivative [Line Items]
Notional amount	28,657	0
Interest Rate Swap Contracts
Derivative [Line Items]
Notional amount	46,322	$ 55,965
After-tax, net unrealized losses on derivatives arising during period	(139)
Net amount expected to be reclassified to earnings in the next 12 months	$ (51)

Derivatives and Risk Manageme_5

Derivatives and Risk Management (Amount of Gain (Loss) Recognized in OCI and Income Statement) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Derivative Instruments, Gain (Loss) [Line Items]
Losses/Gains Recognized in OCI	$ 0	$ 0	$ 0	$ 0
Cash Flow Hedging
Derivative Instruments, Gain (Loss) [Line Items]
Losses/Gains Recognized in OCI	125	(2,537)	314	(10,124)
(Losses) Gains Reclassified from AOCI to Earnings	(568)	(557)	77	(4,201)
Cash Flow Hedging | Foreign exchange and other gains (losses)
Derivative Instruments, Gain (Loss) [Line Items]
(Losses) Gains Reclassified from AOCI to Earnings	2,511	(1,623)	1,999	(6,833)
Cash Flow Hedging | SG&A
Derivative Instruments, Gain (Loss) [Line Items]
(Losses) Gains Reclassified from AOCI to Earnings	(3,007)	269	(1,833)	1,623
Cash Flow Hedging | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
(Losses) Gains Reclassified from AOCI to Earnings	(72)	797	(89)	1,009
Cash Flow Hedging | Foreign Exchange Contract
Derivative Instruments, Gain (Loss) [Line Items]
Losses/Gains Recognized in OCI	125	(2,537)	314	(10,124)
Cash Flow Hedging | Interest Rate Swap Contracts
Derivative Instruments, Gain (Loss) [Line Items]
Losses/Gains Recognized in OCI	$ 0	$ 0	$ 0	$ 0

Derivatives and Risk Manageme_6

Derivatives and Risk Management (Fair Value of Derivative Instruments) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Derivatives, Fair Value [Line Items]
Total asset derivatives	$ 3,309	$ 519
Total liability derivatives	2,304	2,045
Derivatives Designated as Hedging Instruments
Derivatives, Fair Value [Line Items]
Total asset derivatives	0	0
Total liability derivatives	2,080	2,045
Derivatives Designated as Hedging Instruments | Prepaid expenses and other current assets | Interest Rate Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives	0	0
Derivatives Designated as Hedging Instruments | Prepaid expenses and other current assets | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives	0	0
Derivatives Designated as Hedging Instruments | Accrued liabilities | Interest Rate Contract
Derivatives, Fair Value [Line Items]
Total liability derivatives	487	834
Derivatives Designated as Hedging Instruments | Accrued liabilities | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total liability derivatives	1,084	460
Derivatives Designated as Hedging Instruments | Other assets | Interest Rate Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives	0	0
Derivatives Designated as Hedging Instruments | Other long-term liabilities | Interest Rate Contract
Derivatives, Fair Value [Line Items]
Total liability derivatives	509	751
Derivatives Not Designated as Hedging Instruments
Derivatives, Fair Value [Line Items]
Total asset derivatives	3,309	519
Total liability derivatives	224	0
Derivatives Not Designated as Hedging Instruments | Prepaid expenses and other current assets | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives	3,309	519
Derivatives Not Designated as Hedging Instruments | Accrued liabilities | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total liability derivatives	$ 224	$ 0

Commitments and Contingencies (

Commitments and Contingencies (Narrative) (Details) $ in Thousands, € in Millions

Aug. 22, 2018USD ($)

May 15, 2018USD ($)

Oct. 06, 2016USD ($)

Apr. 01, 2016USD ($)

Sep. 30, 2018USD ($)installmentnotice

Sep. 30, 2018USD ($)installmentnotice

Sep. 30, 2018EUR (€)

Dec. 31, 2004USD ($)

Oct. 31, 2018claim

Sep. 30, 2018EUR (€)installmentnotice

Dec. 31, 2017USD ($)

Aug. 27, 2015non-conformity

Oct. 30, 2009USD ($)

Oct. 30, 2009EUR (€)

Other Commitments [Line Items]

Accrual for environmental loss contingencies

$ 17,947

$ 17,947

$ 27,546

Estimate of possible loss

19,600

€ 17

Settled Litigation

Other Commitments [Line Items]

Litigation settlement

$ 480

$ 480

Legal fees

$ 58

Threatened Litigation | Regional Internal Revenue Office of Lombardy

Other Commitments [Line Items]

Losses under dispute

$ 72,500

$ 72,500

€ 62.6

$ 118,800

€ 102.6

Number of equal installments | installment

5

5

5

Number of notice of assessments | notice

3

3

3

FDA Warning Letter

Other Commitments [Line Items]

Number of observed non-conformities | non-conformity

2

Civil Investigative Demand

Other Commitments [Line Items]

Damages expected to be paid

$ 1,900

SNIA | Pending Litigation | SNIA s.p.a

Other Commitments [Line Items]

Compensation sought

$ 4,000,000

SNIA | Settled Litigation | Sorin S.p.A. | Positive Outcome of Litigation

Other Commitments [Line Items]

Litigation settlement

$ 338

Environmental Remediation Order | Pending Litigation | Sorin S.p.A.

Other Commitments [Line Items]

Court expenses

$ 5

Forecast

Other Commitments [Line Items]

Pending claims, number | claim

150

SG&A | Civil Investigative Demand

Other Commitments [Line Items]

Damages expected to be paid

$ 1,900

Stockholders' Equity (Comprehen

Stockholders' Equity (Comprehensive Income) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	$ 1,815,314
Ending Balance	1,784,992
Change in Unrealized Gain (Loss) on Derivatives
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	(919)	$ 3,619
Other comprehensive (loss) income before reclassifications, before tax	314	(10,124)
Tax expense (benefit)	(75)	2,784
Other comprehensive (loss) income before reclassifications, net of tax	239	(7,340)
Reclassification of loss (gain) from accumulated other comprehensive income, before tax	(77)	4,201
Reclassification of tax expense (benefit)	18	(1,028)
Reclassification of loss (gain) from accumulated other comprehensive income, after tax	(59)	3,173
Net current-period other comprehensive (loss) income, net of tax	180	(4,167)
Ending Balance	(739)	(548)
Foreign Currency Translation Adjustments Gain (Loss)
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	46,232	(72,106)
Other comprehensive (loss) income before reclassifications, before tax	(36,727)	111,123
Tax expense (benefit)	0	0
Other comprehensive (loss) income before reclassifications, net of tax	(36,727)	111,123
Reclassification of loss (gain) from accumulated other comprehensive income, before tax	(9,011)	0
Reclassification of tax expense (benefit)	0	0
Reclassification of loss (gain) from accumulated other comprehensive income, after tax	(9,011)	0
Net current-period other comprehensive (loss) income, net of tax	(45,738)	111,123
Ending Balance	494	39,017
Accumulated Other Comprehensive Income (Loss)
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	45,313	(68,487)
Other comprehensive (loss) income before reclassifications, before tax	(36,413)	100,999
Tax expense (benefit)	(75)	2,784
Other comprehensive (loss) income before reclassifications, net of tax	(36,488)	103,783
Reclassification of loss (gain) from accumulated other comprehensive income, before tax	(9,088)	4,201
Reclassification of tax expense (benefit)	18	(1,028)
Reclassification of loss (gain) from accumulated other comprehensive income, after tax	(9,070)	3,173
Net current-period other comprehensive (loss) income, net of tax	(45,558)	106,956
Ending Balance	$ (245)	$ 38,469

Stock-Based Incentive Plan (Com

Stock-Based Incentive Plan (Compensation Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 7,277	$ 5,468	$ 19,427	$ 13,698
Share-based compensation arrangement, compensation cost	3,400		7,300
Service-based stock appreciation rights (SARs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	2,491	2,433	6,514	5,764
Service-based restricted stock units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	3,368	2,135	8,158	6,453
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	509	289	$ 1,814	463
Share-based compensation arrangement, vesting period			3 years
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 909	$ 611	$ 2,941	$ 1,018
Share-based compensation arrangement, vesting period			3 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement, vesting period			4 years

Stock-Based Incentive Plan (Exe

Stock-Based Incentive Plan (Executed Agreements) (Details) shares in Thousands	9 Months Ended
	Sep. 30, 2018$ / sharesshares
Service-based stock appreciation rights (SARs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	648
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 28.13
Service-based restricted stock units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	255
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 95.61
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	43
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 101.50
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	43
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 89.74

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended			9 Months Ended
	Sep. 30, 2018	Dec. 31, 2017	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Income Tax Disclosure [Abstract]
Effective tax rate (percent)	29.80%		6.50%	0.60%	9.60%
Valuation allowance			$ 4
Resolution of prior period tax matters			$ 2.1
Audit settlement	$ 1.7
Income tax expense (benefit)		$ 27.5

Net Income (Loss) Per Share (Sc

Net Income (Loss) Per Share (Schedule of Earnings Per Share, Basic and Diluted) (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Earnings Per Share [Abstract]
Basic weighted average shares outstanding (in Shares)	48,637	48,181	48,484	48,130
Add effects of share-based compensation instruments (in Shares)	0	353	943	209
Diluted weighted average shares outstanding (in Shares)	48,637	48,534	49,427	48,339

Net Income (Loss) Per Share (Na

Net Income (Loss) Per Share (Narrative of Antidilutive Securities Excluded from Computation of Earnings Per Share) (Details) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Stock Compensation Plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share amount (in shares)	2.8	1.6	0.5	1.7

Geographic and Segment Inform_3

Geographic and Segment Information (Segment Info) (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018USD ($)geographic_region	Sep. 30, 2017USD ($)	Sep. 30, 2018USD ($)segmentgeographic_region	Sep. 30, 2017USD ($)	Jan. 16, 2018	Dec. 31, 2017USD ($)
Segment Reporting Information [Line Items]
Reportable segments | segment			2
Ownership percentage (percent)	24.60%		24.60%
Number of geographic regions in which entity operates | geographic_region	3		3
Net sales	$ 272,082	$ 251,253	$ 809,978	$ 733,921
Total reportable segment income from continuing operations	16,795	41,755	79,276	123,678
Merger and integration expenses	12,659	2,010	20,028	7,708
Charges	436	1,183	2,793	13,810
Amortization of intangibles	9,457	8,540	28,075	24,616
Operating (loss) income from continuing operations	(5,757)	30,022	28,380	77,544
Assets	2,610,680		2,610,680			$ 2,503,891
Capital expenditures	12,903	9,081	25,099	24,004
Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Total reportable segment income from continuing operations			36,378	63,594
Charges	354	441	2,093	6,944
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Total reportable segment income from continuing operations			132,377	138,544
Charges	17	(32)	34	407
Other
Segment Reporting Information [Line Items]
Total reportable segment income from continuing operations	(29,420)	(28,557)	(89,479)	(78,460)
Charges	65	774	666	6,459
Assets	299,439		299,439			334,276
Capital expenditures	4,359	1,633	7,058	4,021
ImThera Medical, Inc.
Segment Reporting Information [Line Items]
Ownership percentage (percent)					86.00%
Continuing Operations | Operating Segments
Segment Reporting Information [Line Items]
Net sales	272,082	251,253	809,978	733,921
Continuing Operations | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	166,561	159,822	499,189	457,612
Total reportable segment income from continuing operations	9,783	23,788
Assets	1,548,866		1,548,866			1,386,032
Capital expenditures	8,032	5,541	15,757	13,292
Continuing Operations | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	104,943	91,016	309,440	275,190
Total reportable segment income from continuing operations	36,432	46,524
Assets	762,375		762,375			532,894
Capital expenditures	512	370	1,359	2,348
Discontinued Operations
Segment Reporting Information [Line Items]
Assets	0		0			$ 250,689
Capital expenditures	0	1,537	925	4,343
United States | Continuing Operations | Operating Segments
Segment Reporting Information [Line Items]
Net sales	139,682	121,277	405,804	360,510
United States | Continuing Operations | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	52,488	44,991	151,223	129,160
United States | Continuing Operations | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	87,194	76,286	254,581	231,350
Europe | Continuing Operations | Operating Segments
Segment Reporting Information [Line Items]
Net sales	51,142	48,486	170,494	151,528
Europe | Continuing Operations | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	41,645	40,429	138,763	126,028
Europe | Continuing Operations | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	9,497	8,057	31,731	25,500
Rest of world | Continuing Operations | Operating Segments
Segment Reporting Information [Line Items]
Net sales	81,258	81,490	233,680	221,883
Rest of world | Continuing Operations | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	72,428	74,402	209,203	202,424
Rest of world | Continuing Operations | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	8,252	6,673	23,128	18,340
Rest of world | Continuing Operations | Other
Segment Reporting Information [Line Items]
Net sales	578	415	1,349	1,119
Cardiopulmonary | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	127,940	123,564	389,709	355,007
Cardiopulmonary | United States | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	40,396	38,379	120,980	110,274
Cardiopulmonary | Europe | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	32,186	30,520	104,972	95,088
Cardiopulmonary | Rest of world | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	55,358	54,665	163,757	149,645
Heart Valves | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	32,546	36,258	97,390	102,605
Heart Valves | United States | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	6,145	6,612	18,828	18,886
Heart Valves | Europe | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	9,421	9,909	33,400	30,940
Heart Valves | Rest of world | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	16,980	19,737	45,162	52,779
Advanced Circulatory Support | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	6,075	0	12,090	0
Advanced Circulatory Support | United States | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	5,947	0	11,415	0
Advanced Circulatory Support | Europe | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	38	0	391	0
Advanced Circulatory Support | Rest of world | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	$ 90	$ 0	$ 284	$ 0

Geographic and Segment Inform_4

Geographic and Segment Information (Changes in Carrying Amount of Goodwill) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)
Goodwill [Roll Forward]
Goodwill, beginning	$ 784,242
Goodwill as a result of acquisitions	204,284
Foreign currency adjustments	(19,249)
Goodwill, ending	969,277
Operating Segments | Neuromodulation
Goodwill [Roll Forward]
Goodwill, beginning	315,943
Goodwill as a result of acquisitions	82,596
Foreign currency adjustments	0
Goodwill, ending	398,539
Operating Segments | Cardiovascular
Goodwill [Roll Forward]
Goodwill, beginning	425,882
Goodwill as a result of acquisitions	121,688
Foreign currency adjustments	(19,249)
Goodwill, ending	528,321
Other
Goodwill [Roll Forward]
Goodwill, beginning	42,417
Goodwill as a result of acquisitions	0
Foreign currency adjustments	0
Goodwill, ending	$ 42,417

Geographic and Segment Inform_5

Geographic and Segment Information (Geographic Areas) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 188,460	$ 192,359
United States
Segment Reporting Information [Line Items]
Property, plant and equipment, net	65,776	62,154
Europe
Segment Reporting Information [Line Items]
Property, plant and equipment, net	112,092	119,133
Rest of world
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 10,592	$ 11,072

Supplemental Financial Inform_3

Supplemental Financial Information (Summary of Inventory) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Balance Sheet Related Disclosures [Abstract]
Raw materials	$ 37,839	$ 39,810
Work-in-process	20,321	18,206
Finished goods	94,896	86,454
Inventory, Net	153,056	144,470
Provision for obsolescence	$ 11,500	$ 10,500

Supplemental Financial Inform_4

Supplemental Financial Information (Summary of Accrued Liabilities) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Balance Sheet Related Disclosures [Abstract]
Contingent consideration	$ 18,402	$ 0
Product remediation	15,509	16,811
CRM purchase price adjustment payable to MicroPort Scientific Corporation	14,891	0
Legal and administrative costs	13,041	6,082
Other amounts payable to MicroPort Scientific Corporation	11,419	0
Deferred consideration - Caisson	0	14,300
Other accrued expenses	45,471	41,749
Accrued liabilities	$ 118,733	$ 78,942

New Accounting Pronouncements_2

New Accounting Pronouncements (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Jan. 01, 2018	Dec. 31, 2017
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Prepaid expenses and other current assets	$ 37,666	$ 26,433	$ 39,037
Deferred tax assets, net	65,808	69,860	11,559
Other assets	5,520	7,857	75,984
Accumulated deficit	$ (40,932)	$ (62,094)	(39,664)
Calculated under Revenue Guidance in Effect before Topic 606
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Prepaid expenses and other current assets			39,037
Deferred tax assets, net			11,559
Other assets			75,984
Accumulated deficit			(39,664)
Difference between Revenue Guidance in Effect before and after Topic 606 | Accounting Standards Update 2016-16
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Prepaid expenses and other current assets			(12,604)
Deferred tax assets, net			58,301
Other assets			(68,127)
Accumulated deficit			$ (22,430)