LivaNova (LIVN) 10-K 27 Feb 23 2022 FY Annual report Financial data

Cover Page

Cover Page - USD ($) $ in Billions	12 Months Ended
	Dec. 31, 2022	Feb. 17, 2023	Jun. 30, 2022
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2022
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-37599
Entity Registrant Name	LivaNova PLC
Entity Incorporation, State or Country Code	X0
Entity Tax Identification Number	98-1268150
Entity Address, Address Line One	20 Eastbourne Terrace
Entity Address, City or Town	London
Entity Address, Country	GB
Entity Address, Postal Zip Code	W2 6LG
Country Region	44
City Area Code	0
Local Phone Number	203 325-0660
Title of 12(b) Security	Ordinary Shares - £1.00 par value per share
Trading Symbol	LIVN
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 3.3
Entity Common Stock, Shares Outstanding (in shares)		53,564,597
Documents Incorporated by Reference	Portions of the definitive proxy statement of LivaNova PLC for the 2023 Annual General Meeting of Shareholders, which will be filed within 120 days of December 31, 2022, are incorporated by reference into Part III of this Annual Report on Form 10-K.
Amendment Flag	false
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	FY
Entity Central Index Key	0001639691

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2022
Audit Information [Abstract]
Auditor Firm ID	238
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Houston, Texas

Consolidated Statements of Inco

Consolidated Statements of Income (Loss) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Statement [Abstract]
Net revenue	$ 1,021,805	$ 1,035,365	$ 934,241
Cost of sales	314,577	329,371	339,478
Gross Profit	707,228	705,994	594,763
Operating expenses:
Selling, general & administrative	469,243	471,904	446,561
Research and development	155,805	183,414	152,902
Impairment of disposal group	0	0	180,160
Impairment of goodwill	129,396	0	21,269
Other operating expenses	29,536	51,460	67,770
Operating loss from continuing operations	(76,752)	(784)	(273,899)
Interest expense	(48,250)	(50,151)	(40,837)
Loss on debt extinguishment	0	(60,238)	(1,407)
Foreign exchange and other income/(expense)	49,860	(13,299)	(31,879)
Loss from continuing operations before tax	(75,142)	(124,472)	(348,022)
Income tax expense (benefit)	11,051	11,198	(960)
Losses from equity method investments	(53)	(148)	(264)
Net loss from continuing operations	(86,246)	(135,818)	(347,326)
Net loss from discontinued operations, net of tax	0	0	(1,493)
Net loss	$ (86,246)	$ (135,818)	$ (348,819)
Basic net loss per share:
Continuing operations (in dollars per share)	$ (1.61)	$ (2.68)	$ (7.15)
Discontinued operations (in dollars per share)	0	0	(0.03)
Basic (loss) income per share (in dollars per share)	(1.61)	(2.68)	(7.18)
Diluted net loss per share:
Continuing operations (in dollars per share)	(1.61)	(2.68)	(7.15)
Discontinued operations (in dollars per share)	0	0	(0.03)
Diluted (loss) income per share (in dollars per share)	$ (1.61)	$ (2.68)	$ (7.18)
Weighted average shares used in computing net loss per share:
Basic (in shares)	53,472	50,633	48,592
Diluted (in shares)	53,472	50,633	48,592

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Statement of Comprehensive Income [Abstract]
Net loss	$ (86,246)	$ (135,818)	$ (348,819)
Other comprehensive (loss) income:
Net change in unrealized (loss) gain on derivatives	1,911	(3,997)	2,379
Tax effect	0	733	(573)
Net of tax	1,911	(3,264)	1,806
Foreign currency translation adjustment, net of tax	(42,853)	(31,722)	45,395
Total other comprehensive (loss) income	(40,942)	(34,986)	47,201
Total comprehensive loss	$ (127,188)	$ (170,804)	$ (301,618)

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Current Assets:
Cash and cash equivalents	$ 214,172	$ 207,992
Restricted cash	301,446	0
Accounts receivable, net of allowance of $11,862 at December 31, 2022 and $13,512 at December 31, 2021	183,110	185,354
Inventories	129,379	105,840
Prepaid and refundable taxes	31,708	37,621
Current derivative assets	1,333	106,629
Prepaid expenses and other current assets	24,988	35,745
Total Current Assets	886,136	679,181
Property, plant and equipment, net	147,187	150,066
Goodwill	768,787	899,525
Intangible assets, net	368,559	399,682
Operating lease assets	35,830	40,600
Investments	16,266	16,598
Deferred tax assets	1,384	2,197
Long-term derivative assets	54,393	0
Other assets	16,231	13,102
Total Assets	2,294,773	2,200,951
Current Liabilities:
Current debt obligations	23,434	229,673
Accounts payable	74,310	68,000
Accrued liabilities and other	75,595	88,937
Current derivative liabilities	5,886	183,109
Current litigation provision liability	29,481	32,845
Taxes payable	16,505	15,140
Accrued employee compensation and related benefits	72,187	79,266
Total Current Liabilities	297,398	696,970
Long-term debt obligations	518,067	9,849
Contingent consideration	85,292	86,830
Deferred tax liabilities	8,516	7,728
Long-term operating lease liabilities	29,548	35,919
Long-term employee compensation and related benefits	16,804	19,105
Long-term derivative liabilities	85,675	0
Other long-term liabilities	45,849	49,905
Total Liabilities	1,087,149	906,306
Commitments and contingencies (Note 14)
Stockholders’ Equity:
Ordinary Shares, £1.00 par value: unlimited shares authorized; 53,851,979 shares issued and 53,564,664 shares outstanding at December 31, 2022; 53,761,510 shares issued and 53,263,297 shares outstanding at December 31, 2021	82,424	82,295
Additional paid-in capital	2,157,724	2,117,961
Accumulated other comprehensive (loss) income	(48,119)	(7,177)
Accumulated deficit	(984,030)	(897,784)
Treasury stock at cost, 287,315 ordinary shares at December 31, 2022, 498,213 ordinary shares at December 31, 2021	(375)	(650)
Total Stockholders’ Equity	1,207,624	1,294,645
Total Liabilities and Stockholders’ Equity	$ 2,294,773	$ 2,200,951

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) $ in Thousands	Dec. 31, 2022 USD ($) shares	Dec. 31, 2021 USD ($) shares
Statement of Financial Position [Abstract]
Allowance for doubtful accounts | $	$ 11,862	$ 13,512
Ordinary shares issued (in shares)	53,851,979	53,761,510
Ordinary shares outstanding (in shares)	53,564,664	53,263,297
Treasury stock (in shares)	287,315	498,213

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Cumulative Effect, Period of Adoption, Adjustment	Ordinary Shares	Additional Paid-In Capital	Treasury Stock	Accumulated Other Comprehensive (Loss) Income	Accumulated Deficit	Accumulated Deficit Cumulative Effect, Period of Adoption, Adjustment
Beginning balance (in shares) at Dec. 31, 2019			49,411,000
Beginning balance at Dec. 31, 2019	$ 1,377,964	$ (639)	$ 76,257	$ 1,734,870	$ (1,263)	$ (19,392)	$ (412,508)	$ (639)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation plans (in shares)			109,000
Stock-based compensation plans	33,558		$ 140	33,189	229
Cancellation of shares (in shares)			(73,000)
Cancellation of shares	0		$ (97)	97
Net loss	(348,819)						(348,819)
Other comprehensive income (loss)	47,201					47,201
Ending balance (in shares) at Dec. 31, 2020			49,447,000
Ending balance at Dec. 31, 2020	$ 1,109,265		$ 76,300	1,768,156	(1,034)	27,809	(761,966)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Accounting Standards Update [Extensible List]	Accounting Standards Update 2016-13 [Member]
Shares issuance (in shares)			4,182,000
Issuance of shares	$ 322,541		$ 5,808	316,733
Stock-based compensation plans (in shares)			133,000
Stock-based compensation plans	33,643		$ 187	33,072	384
Net loss	(135,818)						(135,818)
Other comprehensive income (loss)	$ (34,986)					(34,986)
Ending balance (in shares) at Dec. 31, 2021	53,761,510		53,762,000
Ending balance at Dec. 31, 2021	$ 1,294,645		$ 82,295	2,117,961	(650)	(7,177)	(897,784)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation plans (in shares)			90,000
Stock-based compensation plans	40,167		$ 129	39,763	275
Net loss	(86,246)						(86,246)
Other comprehensive income (loss)	$ (40,942)					(40,942)
Ending balance (in shares) at Dec. 31, 2022	53,851,979		53,852,000
Ending balance at Dec. 31, 2022	$ 1,207,624		$ 82,424	$ 2,157,724	$ (375)	$ (48,119)	$ (984,030)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Operating Activities:
Net loss	$ (86,246)	$ (135,818)	$ (348,819)
Non-cash items included in net loss:
Impairment of goodwill	129,396	0	21,269
Stock-based compensation	44,809	40,564	35,089
Remeasurement of derivative instruments	(38,656)	17,618	22,085
Remeasurement of contingent consideration to fair value	(29,881)	564	(20,463)
Amortization	25,198	26,517	38,312
Depreciation	22,373	24,536	29,031
Amortization of debt issuance costs	21,334	16,657	9,710
Amortization of operating lease assets	10,225	16,935	13,977
Deferred tax expense	1,409	2,852	37,068
Loss on debt extinguishment	0	60,238	1,407
Impairment of long-lived assets	0	0	6,762
Impairment of disposal group and loss on sale	0	1,942	180,160
Other	1,653	717	2,000
Changes in operating assets and liabilities:
Accounts receivable, net	(4,810)	(15,745)	58,796
Inventories	(25,679)	4,484	5,438
Other current and non-current assets	7,486	24,127	(39,645)
Accounts payable and accrued current and non-current liabilities	(3,510)	12,993	(923)
Taxes payable	1,378	103	3,596
Litigation provision liability	(6,558)	3,260	(134,272)
Net cash provided by (used in) operating activities	69,921	102,544	(79,422)
Investing Activities:
Purchases of property, plant and equipment	(26,517)	(25,478)	(35,024)
Acquisitions, net of cash acquired	(8,857)	(1,694)	(1,719)
Purchase of investments	(2,952)	(3,653)	(3,184)
Proceeds from sale of Heart Valves, net of cash disposed	0	42,945	0
Proceeds from sale of Respicardia investment and loan	0	23,057	0
Other	(88)	1,727	(1,917)
Net cash (used in) provided by investing activities	(38,414)	36,904	(41,844)
Financing Activities:
Proceeds from long-term debt obligations	507,547	0	886,899
Repayment of long-term debt obligations	(223,541)	(452,256)	(482,065)
Shares repurchased from employees for minimum tax withholding	(8,671)	(12,942)	(5,601)
Proceeds from deferred consideration from sale of Heart Valves, net of working capital adjustments	4,596	0	0
Debt issuance costs	(3,292)	(2,450)	(23,736)
Proceeds from issuance of ordinary shares, net	0	322,557	0
Payment of make-whole premium on long-term debt obligations	0	(35,594)	0
Payment of contingent consideration	0	(5,249)	(12,018)
Proceeds from short term borrowings (maturities greater than 90 days)	0	0	47,053
Repayments of short term borrowings (maturities greater than 90 days)	0	0	(44,838)
Purchase of capped call	0	0	(43,096)
Closing adjustment payment for sale of CRM business	0	0	(14,891)
Other	3,491	4,451	3,049
Net cash provided by (used in) financing activities	280,130	(181,483)	310,756
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(4,011)	(2,805)	2,205
Net increase (decrease) in cash, cash equivalents and restricted cash	307,626	(44,840)	191,695
Cash, cash equivalents and restricted cash at beginning of period	207,992	252,832	61,137
Cash, cash equivalents and restricted cash at end of period	515,618	207,992	252,832
Supplementary Disclosures of Cash Flow Information:
Cash paid for interest	19,044	32,569	28,573
Cash paid for income taxes, net	$ 1,221	$ (13,583)	$ 7,493

Nature of Operations

Nature of Operations	12 Months Ended
	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Operations	Note 1. Nature of Operations Description of the Business LivaNova PLC, headquartered in London, (collectively with its subsidiaries, the “Company,” “LivaNova,” “we” or “our”) is a global medical device company. We design, develop, manufacture and sell products and therapies that are consistent with our mission to provide hope for patients and their families through innovative medical technologies, delivering life-changing improvements for both the Head and Heart. We are a public limited company organized under the laws of England and Wales, and headquartered in London, England. Business Segments LivaNova is comprised of three reportable segments: Cardiopulmonary, Neuromodulation and Advanced Circulatory Support, corresponding to our primary business units. Macroeconomic Environment The current macroeconomic environment, including foreign exchange volatility, supply chain challenges, rising inflation, and geopolitical instability, has impacted and may continue to impact our business. In 2022, our net revenue and profitability were negatively affected by the unfavorable foreign currency exchange impact of the strengthened United States (“U.S.”) dollar against a number of currencies. Furthermore, we continue to experience supply chain delays and interruptions, labor shortages, inflationary pressures and logistical issues in the wake of COVID-19. Though, to date, our supply of raw materials and the production and distribution of finished products have not been materially affected, demand and low capacity worldwide have caused longer lead times and put price pressure on key raw materials. Moreover, freight and labor costs at our manufacturing facilities have increased substantially due to COVID-related disruptions and in the wake of inflation globally. The Company continues to respond to such challenges, and while we have business continuity plans in place, the impact of the ongoing challenges we are experiencing, along with their potential escalation, may adversely affect our business. The future impact of pandemic-related developments remains uncertain.

Basis of Presentation, Use of A

Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies	Note 2. Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies Basis of Presentation The accompanying consolidated financial statements of LivaNova have been prepared in accordance with accounting principles generally accepted in the U.S. (“U.S. GAAP”). Consolidation The accompanying consolidated financial statements for LivaNova include LivaNova’s wholly owned subsidiaries and the LivaNova PLC Employee Benefit Trust (“the Trust”). All intercompany accounts and transactions have been eliminated. Use of Estimates The preparation of our consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in such financial statements and accompanying notes. These estimates are based on management’s best knowledge of current events and actions we may undertake in the future. Estimates are used in accounting for, among other items, valuation and amortization of intangible assets, goodwill, measurement of deferred tax assets and liabilities, uncertain income tax positions, contingent consideration arrangements, legal and other contingencies, stock-based compensation, obsolete and slow-moving inventories, models, such as an impairment analysis, and in general, allocations to provisions and the fair value of assets and liabilities recorded in a business combination. Actual results could differ materially from those estimates. Reclassifications We have reclassified certain prior period amounts on the consolidated statements of income (loss) and the consolidated statements of cash flows for comparative purposes. These reclassifications did not have a material effect on our financial condition, results of operations or cash flows. Cash and Cash Equivalents We consider all highly liquid investments with an original maturity of three months or less, consisting of demand deposit accounts and money market mutual funds, to be cash equivalents. Cash equivalents are carried on the consolidated balance sheet at cost, which approximates their fair value. Restricted Cash The Company classifies cash that is not available for use in its operations as restricted cash within current assets on the consolidated balance sheet. As of December 31, 2022, our restricted cash balance totaled $301.4 million and was comprised of cash deposits with Barclays held as collateral for the SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. For additional information regarding the SNIA litigation, please refer to “Note 14. Commitments and Contingencies.” Accounts Receivable Our accounts receivable consisted of trade receivables from direct customers and distributors. We maintain an allowance for doubtful accounts for potential credit losses based on our estimates of the ability of customers to make required payments, historical credit experience, existing economic conditions and expected future trends. We write off uncollectible accounts against the allowance when all reasonable collection efforts have been exhausted. Inventories We state our inventories at the lower of cost, using the first-in first-out (“FIFO”) method, or net realizable value. Our calculation of cost includes the acquisition cost of raw materials and components, direct labor and overhead, including depreciation of manufacturing related assets. We reduce the carrying value of inventories for those items that are potentially excess, obsolete or slow moving based on changes in customer demand, technology developments or other economic factors. Property, Plant and Equipment (“PP&E”) PP&E is carried at cost, less accumulated depreciation. Maintenance, repairs and minor replacements are charged to expense as incurred, while significant renewals and improvements are capitalized. We compute depreciation using the straight-line method over estimated useful lives. Leasehold improvements are depreciated over the shorter of the following terms: the useful life of the asset or a term that includes required lease periods and renewals that are deemed to be reasonably assured at the date the leasehold improvements are purchased. Capital improvements to the building are added as building components and depreciated over the useful life of the improvement or the building, whichever is less. Goodwill We allocate the amounts we pay for an acquisition to the assets we acquire and liabilities we assume based on their fair values at the date of acquisition, including property, plant and equipment, inventories, accounts receivable, long-term debt, and identifiable intangible assets which either arise from a contractual or legal right or are separable from goodwill. We base the fair value of identifiable intangible assets acquired in a business combination, including IPR&D, on valuations that use information and assumptions provided by management, which consider management’s best estimates of inputs and assumptions that a market participant would use. We allocate any excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired to goodwill. Transaction costs associated with these acquisitions are expensed as incurred and are reported in selling, general and administrative on the consolidated statements of income (loss). We recognize adjustments to the provisional amounts identified during the measurement period with a corresponding adjustment to goodwill in the reporting period in which the adjustment amounts are determined. The effect on earnings of changes in depreciation, amortization or other income effects, if any, as a result of the change to the provisional amounts are recorded in the same period’s consolidated financial statements, calculated as if the accounting had been completed at the acquisition date. Intangible Assets, Other than Goodwill Intangible assets shown on the consolidated balance sheets consist of finite-lived and indefinite-lived assets expected to generate future economic benefits and are recorded at their respective fair values as of their acquisition date. Finite-lived intangible assets consist primarily of developed technology and technical capabilities, including patents, related know-how and licensed patent rights, trade names and customer relationships. Customer relationships consist of relationships with hospitals and surgeons in the countries where we operate. Indefinite-lived intangible assets other than goodwill are composed of IPR&D assets acquired in acquisitions. We estimate the useful lives of our intangible assets, which requires significant management judgment. We amortize our finite-lived intangible assets over their useful lives using the straight-line method. Amortization expense is included on our consolidated statements of income (loss) within cost of sales or selling, general and administrative (“SG&A”) based on the nature of the underlying intangible asset. We evaluate our intangible assets each reporting period to determine whether events and circumstances indicate either a different useful life or impairment. If we change our estimate of the useful life of an asset, we amortize the carrying amount over the revised remaining useful life. Impairments of Long-lived Assets and Goodwill Long-lived Assets Impairment Assets Held and Used We evaluate the carrying value of our long-lived assets and investments for impairment when events or changes in circumstances indicate that the carrying value of such assets may not be recoverable. Such changes in circumstance may include, among other items, (i) an expectation of a sale or disposal of a long-lived asset or asset group, (ii) adverse changes in market or competitive conditions, (iii) an adverse change in legal factors or business climate in the markets in which we operate and (iv) operating or cash flow losses. For PP&E and intangible assets used in our operations, recoverability generally is determined by comparing the carrying value of an asset or group of assets to their expected undiscounted future cash flows. If the carrying value of an asset (asset group) is not recoverable, the amount of impairment loss is measured as the difference between the carrying value of the asset (asset group) and its estimated fair value. The asset grouping as well as the determination of expected undiscounted cash flow amounts requires significant judgments, estimates, and assumptions, including cash flows generated upon disposition. We measure fair value as the price that would be received if we were to sell the assets in an orderly transaction. Assets to be disposed of are carried at the lower of their financial statement carrying amount or fair value less costs to sell. We conduct impairment testing of our indefinite-lived intangible assets on October 1st each year. We test indefinite-lived intangible assets for impairment between annual tests if an event occurs or circumstances change that would indicate the carrying amount may be impaired. An impairment loss is recognized when the asset's carrying value exceeds its fair value. Assets Held for Sale We classify long-lived assets as held for sale in the period in which we commit to a plan to sell the asset, the asset is available for immediate sale, the asset is being actively marketed for sale at a price that is reasonable in relation to its current fair value and the sale of the asset is probable within the next twelve months and when actions required to complete the plan indicate that it is unlikely that significant changes to the plan will be made or that the plan will be withdrawn. A long-lived asset classified as held for sale is measured at the lower of its carrying amount or fair value less cost to sell and depreciation is discontinued. We recognize an impairment for any excess of carrying value over the fair value less cost to sell. When an impairment of a disposal group is deemed necessary and the amount of the impairment exceeds the carrying value of the long-lived assets, we record the impairment to the disposal group rather than long-lived assets. We also allocate goodwill of the associated reporting unit to the disposal group based upon the relative fair value of the businesses within the reporting unit. The goodwill allocated to the disposal group is then tested for impairment. Goodwill Impairment We conduct impairment testing of our goodwill on October 1st each year. Testing is performed at the reporting unit level, which is defined as an operating segment or a component of an operating segment that constitutes a business for which financial information is available and is regularly viewed by management. Our operating segments are deemed to be our reporting units for purposes of goodwill impairment testing. We test goodwill for impairment between annual tests if an event occurs or circumstances change that would more-likely-than-not reduce the fair value of a reporting unit below its carrying amount. If we determine that goodwill is more-likely-than-not impaired, we compare the fair value of the reporting unit to its carrying amount, including goodwill. Fair value refers to the price that would be received if we were to sell the unit as a whole in an orderly transaction. Fair value is estimated using a discounted cash flow model and requires various assumptions, including revenue growth rates. If the carrying amount of our reporting unit is greater than zero and its fair value exceeds its carrying amount, goodwill of the reporting unit is considered not impaired. An impairment loss is recognized when the carrying amount of the reporting unit’s net assets exceeds the estimated fair value of the reporting unit, up to and including the carrying amount of the goodwill. If the aggregate fair value of our reporting units exceeds our market capitalization, we evaluate the reasonableness of the implied control premium which includes a comparison to implied control premiums from recent market transactions within our industry or other relevant benchmark data. Goodwill impairment evaluations are highly subjective. In most instances, they involve expectations of future cash flows that reflect our judgments and assumptions regarding future industry conditions and operations. The estimates, judgments and assumptions used in the application of our goodwill impairment policies reflect both historical experience and an assessment of current operational, industry, market, economic and political environments. The use of different estimates, judgments, assumptions and expectations regarding future industry and market conditions and operations would likely result in materially different asset carrying values and operating results. Quantitative factors used to determine the fair value of the reporting units reflect our best estimates, and we believe they are reasonable. Future declines in the reporting units’ operating performance or our anticipated business outlook may reduce the estimated fair value of our reporting units and result in an impairment. Factors that could have a negative impact on the fair value of the reporting units include, but are not limited to: • decreases in revenue as a result of the inability of our sales force to effectively market and promote our products; • increased competition, patent expirations or new technologies or treatments; • declines in anticipated growth rates; • the outcome of litigation, legal proceedings, investigations or other claims resulting in significant cash outflows; and • increases in the market-participant risk-adjusted Weighted Average Cost of Capital (“WACC”). Derivatives and Risk Management U.S. GAAP requires companies to recognize all derivatives as assets and liabilities on the balance sheet and to measure the instruments at fair value through earnings unless the derivative qualifies for hedge accounting. 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 other comprehensive income (“OCI”) until the hedged item is recognized in earnings. The changes in the fair value of the derivative are intended to offset the change in fair value of the hedged asset, liability or probable commitment. We evaluate hedge effectiveness at inception. Cash flows from derivative contracts are reported as operating activities on the consolidated statements of cash flows. We use currency exchange rate derivative contracts to manage the impact of currency exchange on earnings and cash flows. Forward currency exchange rate contracts are designed to hedge anticipated foreign currency transactions and changes in the value of specific assets and liabilities. At inception of the forward contract, the derivative is designated as either a freestanding derivative or a cash flow hedge. We do not enter into derivative contracts for speculative purposes. All derivative instruments are recorded at fair value on the consolidated balance sheets, as assets or liabilities (current or non-current) depending upon the gain or loss position of the contract and contract maturity date. Forward contracts designated as cash flow hedges are designed to hedge the variability of cash flows associated with forecasted transactions denominated in a foreign currency that will take place in the future. For derivative instruments that are designated and qualify as a cash flow hedge, the gain or loss on the derivative instrument is reported as a component of accumulated other comprehensive income (“AOCI”) and reclassified into earnings to offset exchange differences originated by the hedged item or the current earnings effect of the hedged item. Upon the settlement of our foreign currency cash flow hedges in the fourth quarter of 2022 and following an in-depth analysis of the utility of our cash flow hedging program, we discontinued our foreign currency cash flow hedging program. We continue to use freestanding derivative forward contracts to offset exposure to the variability of the value associated with assets and liabilities denominated in a foreign currency. These derivatives are not designated as hedges, and therefore changes in the value of these forward contracts are recognized in earnings, thereby offsetting the current earnings effect of the related change in value of foreign currency denominated assets and liabilities. We currently use interest rate derivative instruments designated as cash flow hedges to manage the exposure to interest rate movements and to reduce the risk of increased borrowing costs by converting floating-rate debt into fixed-rate debt. Under these agreements, we agree to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to agreed-upon notional principal amounts. The interest rate swaps are structured to mirror the payment terms of the underlying loan. The fair value of the interest rate swaps is reported on the consolidated balance sheets as assets or liabilities (current or non-current) depending upon the gain or loss position of the contract and the maturity of the future cash flows of each contract. The gain or loss on these derivatives is reported as a component of AOCI and reclassified to interest expense during the period of the respective interest payment. Fair Value Measurements We follow the authoritative guidance on fair value measurements and disclosures with respect to assets and liabilities that are measured at fair value on both a recurring and nonrecurring basis. Under this guidance, fair value is defined as the exit price, or the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants as of the measurement date. The authoritative guidance also establishes a hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability, based on market data obtained from sources independent of us. Unobservable inputs are inputs that reflect our assumptions about the factors market participants would use in valuing the asset or liability developed based upon the best information available in the circumstances. The categorization of financial assets and financial liabilities within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement. The hierarchy is broken down into three levels defined as follows: • Level 1 - Inputs are quoted prices in active markets for identical assets or liabilities; • Level 2 - Inputs include quoted prices for similar assets or liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs (other than quoted prices) that are observable for the asset or liability, either directly or indirectly; and • Level 3 - Inputs are unobservable for the asset or liability. Our financial assets and liabilities classified as Level 2 include derivative instruments, primarily forward and option currency contracts and interest rate swap contracts, which are valued using standard calculations and models that use readily observable market data as their basis. Our financial assets and liabilities classified as Level 3 include contingent consideration liability arrangements, derivative and embedded derivative instruments and convertible notes receivable. Contingent consideration liabilities are from arrangements resulting from acquisitions that involve potential future payment of consideration that is contingent upon the achievement of performance milestones and sales-based earn-outs. Contingent consideration is recognized at fair value at the date of acquisition based on the consideration expected to be transferred and estimated as the probability of future cash flows, discounted to present value in accordance with accepted valuation methodologies. The discount rate used is determined at the time of measurement. Contingent consideration is remeasured each reporting period with the change in fair value, including accretion for the passage of time, recorded in earnings. The change in fair value of contingent consideration based on the achievement of regulatory milestones is recorded as research and development expense while the change in fair value of sales-based earnout contingent consideration is recorded as cost of sales. Contingent consideration payments made soon after the acquisition date are classified as an investing activity. Contingent consideration payments that are not made soon after the acquisition date are classified as a financing activity up to the amount of the contingent consideration liability recognized at the acquisition date, with any excess classified as an operating activity. For further information on our Level 3 contingent consideration liability arrangements, please refer to “Note 10. Fair Value Measurements.” For further information on our Level 3 derivative and embedded derivative instruments, please refer to “Note 11. Financing Arrangements” and “Note 10. Fair Value Measurements.” For further information on our Level 3 convertible notes receivable, please refer to “Note 9. Investments.” Investments in Equity Securities Our investments in equity securities, and related loans, are investments in affiliates that are in varied stages of development and not publicly traded. Our equity investments are reported in investments, and related loans in other assets, on the consolidated balance sheets. We elect to measure 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. Our investments in affiliates in which we have significant influence but not control are accounted for using the equity method. Our share of net income or loss is reflected as one line item on our consolidated statements of income (loss) under losses from losses from equity-method investments and will increase or decrease, as applicable, the carrying value of our equity method investments reported under investments on the consolidated balance sheets. We regularly review our investments for changes in circumstance or the occurrence of events that suggest our investment may not be recoverable, and if an impairment is considered to be other-than-temporary, the loss is recognized on the consolidated statements of income (loss) in the period the determination is made and reported as losses from equity-method investments. Warranty Obligation We offer a warranty on various products. We estimate the costs that may be incurred under warranties and record a liability in the amount of such costs at the time the product is sold. The amount of the reserve recorded is equal to the net costs to repair or otherwise satisfy the claim. We include the warranty obligation in accrued liabilities and other on the consolidated balance sheets. Warranty expense is recorded to cost of goods sold on our consolidated statements of income (loss). Retirement Benefit Plan Assumptions We sponsor various retirement benefit plans, including defined benefit pension plans (pension benefits), defined contribution savings plans and termination indemnity plans, covering substantially all U.S. employees and employees outside the U.S. Pension benefit costs include assumptions for the discount rate, retirement age, compensation rate increases and the expected return on plan assets. Product Liability Accruals Accruals for product liability claims are recorded when it is probable that a liability has been incurred and the amount of the liability can be reasonably estimated based on existing information. Accruals for product liability claims are adjusted periodically as additional information becomes available. Revenue Recognition Refer to “Note 3. Revenue Recognition.” Research and Development All R&D costs are expensed as incurred. R&D includes costs of basic research activities as well as engineering and technical effort required to develop a new product or make significant improvements to an existing product or manufacturing process. R&D costs also include regulatory and clinical study expenses, including post-market clinical studies. Leases We determine if an arrangement is or contains a lease at its inception. For operating leases with a term greater than 12 months, we recognize operating lease assets and operating lease liabilities based on the present value of the future minimum lease payments over the lease term at the latter of our lease standard adoption date of January 1, 2019, or the lease commencement date. We do not record an operating lease asset and corresponding liability for leases with terms of 12 months or less. We recognize the lease payments for such short-term leases within profit and loss on a straight-line basis over the lease term. Variable lease payments, such as common area rent, maintenance charges, and rent escalations not known upon lease commencement, are not included in the determination of the minimum lease payments and are expensed in the period in which the obligation for those payments is incurred. The operating lease asset also includes any lease payments made in advance and excludes lease incentives. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. As most of our leases do not provide a readily determinable implicit rate, we use our incremental borrowing rate (“IBR”) based on the information available at the lease commencement date in determining the present value of future payments. Our IBR represents an estimate of the interest rate we would incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis over the lease term within a particular currency environment. We used the IBR available nearest to our adoption date for leases that commenced prior to that date. Additionally, we monitor for events or changes in circumstances that may require a reassessment of our leases and determine if a remeasurement is required. For additional information, refer to “Note 13. Leases.” Stock-Based Compensation Stock-Based Awards We may grant stock-based awards to directors, officers and key employees. We measure the cost of employee services received in exchange for an award of equity instruments based on the grant date fair market value of the award. We recognize equity-based compensation expense ratably over the period that an employee is required to provide service in exchange for the entire award (all vesting periods). We issue new shares upon stock option exercises, otherwise issuance of stock for vesting of restricted stock units or exercises of stock appreciation rights are issued from treasury shares. We have the right to elect to pay the cash value of vested restricted stock units in lieu of the issuance of new shares. Stock Appreciation Rights (“SARs”) A SAR confers upon an employee the contractual right to receive an amount of cash, stock, or a combination of both that equals the appreciation in the company’s stock from an award’s grant date to the exercise date. SARs may be exercised at the employee’s discretion during the exercise period and do not give the employee an ownership right in the underlying stock. SARs do not involve payment of an exercise price. We use the Black-Scholes option pricing methodology to calculate the grant date fair market value of SARs and compensation is expensed ratably over the service period. We determine the expected volatility of the awards based on historical volatility. Calculation of compensation for stock awards requires estimation of volatility, employee turnover and forfeiture rates. Restricted Stock Units (“RSUs”) We may grant RSUs at no purchase cost to the grantee. The grantees of unvested RSUs have no voting rights or rights to dividends. Sale or transfer of the stock and stock units is restricted until they are vested. The fair market value of service-based RSUs is determined using the market closing price on the grant date, and compensation is expensed ratably over the service period. Calculation of compensation for stock awards requires estimation of employee turnover and forfeiture rates. Market Performance-Based RSU’s We may grant market performance-based RSUs at no purchase cost to the grantee. The grantees of the units have no voting rights or rights to dividends. Sale or transfer of the units is restricted until they are vested. The number of shares that are ultimately transferred to the grantee is dependent upon the Company’s percentile rank of total shareholder return relative to a peer group. The fair market value of market performance-based RSUs is determined utilizing a Monte Carlo simulation on the grant date and compensation is expensed ratably over the service period. Calculation of compensation for market performance-based stock awards requires estimation of employee turnover, historical volatility and forfeiture rates. Operating Performance-Based Awards RSU’s We may grant operating performance-based RSUs at no purchase cost to the grantee. The grantees of the units have no voting rights or rights to dividends. Sale or transfer of the units is restricted until they are vested. The number of shares that are ultimately transferred to the grantee is dependent upon the Company’s achievement of certain thresholds for cumulative adjusted free cash flow and adjusted return on invested capital. The fair market value of operating performance-based RSUs is determined using the market closing price on the grant date. Compensation is expensed ratably over the service period and adjusted based upon the percent achievement of cumulative adjusted free cash flow. Calculation of compensation expense for operating performance-based stock awards requires estimation of employee turnover, adjusted free cash flow, adjusted return on invested capital and forfeiture rates. Income Taxes We are a UK corporation, and we operate through our various subsidiaries in a number of countries throughout the world. Our provision for income taxes is based on the tax laws and rates applicable in the jurisdictions in which we operate and earn income. We use significant judgment and estimates in accounting for our income taxes. We recognize deferred tax assets and liabilities for the anticipated future tax effects of temporary differences between the financial statements basis and the tax basis of our assets and liabilities, which are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. We periodically assess the recoverability of our deferred tax assets by considering whether it is more-likely-than-not that some or all of the actual benefit of those assets will be realized. To the extent that realization does not meet the “more-likely-than-not” criterion, we establish a valuation allowance. We periodically review the adequacy and necessity of the valuation allowance by considering significant positive and negative evidence relative to our ability to recover deferred tax assets and to determine the timing and amount of valuation allowance that should be released. This evidence includes: profitability in the most recent quarters; internal forecasts for the current and next two future years; size of deferred tax asset relative to estimated profitability; the potential effects on future profitability from increasing competition, healthcare reforms and overall economic conditions; limitations and potential limitations on the use of our net operating losses due to ownership changes, pursuant to Internal Revenue Code (“IRC”) Section 382; and the implementation of prudent and feasible tax planning strategies, if any. We file federal and local tax returns in many jurisdictions throughout the world and are subject to income tax examinations for our fiscal year 2015 and subsequent years, with certain exceptions. While we believe that our tax return positions are fully supported, tax authorities may disagree with certain positions we hav

Revenue Recognition

Revenue Recognition	12 Months Ended
	Dec. 31, 2022
Revenue Recognition and Deferred Revenue [Abstract]
Revenue Recognition	Note 3. 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 consolidated 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 have been capitalized as contract costs since adoption of ASC 606. 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 20. Geographic and Segment Information.” Cardiopulmonary Products and Services Cardiopulmonary products include HLMs, oxygenators, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. 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. 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 Cardiopulmonary revenue and have been presented with the related equipment and accessories revenue. Neuromodulation Products Neuromodulation products are comprised of neuromodulation therapy systems for the treatment of drug-resistant epilepsy (“DRE”) and difficult-to-treat depression (“DTD”). Our Neuromodulation product line includes the Vagus Nerve Stimulation Therapy (“VNS Therapy”) System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. We recognize revenue for Neuromodulation product sales when control passes to the customer. Advanced Circulatory Support Products Advanced Circulatory Support (“ACS”) products are comprised of the LifeSPARC platform, ProtekDuo cannula kits and the Hemolung Respiratory Assist System (“Hemolung RAS”). The LifeSPARC platform includes a common compact console and pump that provides temporary support for emergent rescue patients in a variety of settings. The platform is accompanied by four specialized ProtekDuo cannula kits designed to support diverse cannulation strategies. The Hemolung RAS, which was acquired in May 2022 as part of the acquisition of ALung, is the only FDA-cleared platform designed specifically for low-flow extracorporeal carbon dioxide removal for acute respiratory failure. Advanced Circulatory Support revenue is recognized when control passes to the customer, usually at the point of shipment. Contract Balances Due to the nature of our products and services, revenue producing activities may result in contract assets and contract liabilities. These activities relate primarily to Cardiopulmonary 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 on the consolidated balance sheets and were insignificant as of December 31, 2022 and 2021. As of December 31, 2022 and 2021, contract liabilities of $14.1 million and $9.8 million, respectively, were included within accrued liabilities and other and other long-term liabilities on the consolidated balance sheets.

Business Combinations

Business Combinations	12 Months Ended
	Dec. 31, 2022
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Note 4. Business Combinations As of December 31, 2021, LivaNova owned a 3% equity interest in ALung Technologies, Inc. (“ALung”), a medical device company focused on creating advanced medical devices for treating respiratory failure. In May 2022, we acquired the remaining 97% of equity interests in ALung for a purchase price of up to $110.0 million, consisting of $10.0 million paid at closing, subject to customary adjustments, and contingent consideration of up to $100.0 million payable upon achievement of certain sales-based milestones beginning in 2023 and ending in 2027. Total consideration included approximately $5.5 million of non-cash consideration. The following table presents the acquisition date fair value of the consideration transferred and the fair value of our interest in ALung prior to the acquisition, including certain measurement period adjustments (in thousands): Initial Fair Value of Consideration Measurement Period Adjustments (1) Adjusted Fair Value of Consideration Cash and other considerations $ 15,586 $ — $ 15,586 Contingent consideration 26,369 (9,578) 16,791 Fair value of consideration transferred $ 41,955 $ (9,578) $ 32,377 (1) During the third quarter of 2022, measurement period adjustments were recorded based on information obtained about facts and circumstances that existed as of the acquisition date. The following table presents the preliminary purchase price allocation at fair value for the ALung acquisition, including certain measurement period adjustments (in thousands): Initial Purchase Price Allocation Measurement Period Adjustments (1) Adjusted Purchase Price Allocation Developed technology - 15-year life $ 13,950 $ (11,050) $ 2,900 Goodwill 25,893 977 26,870 Other assets and liabilities, net 2,112 495 2,607 Net assets acquired $ 41,955 $ (9,578) $ 32,377 (1) During the third quarter of 2022, measurement period adjustments were recorded based on information obtained about facts and circumstances that existed as of the acquisition date. Goodwill arising from the ALung acquisition, which is not deductible for tax purposes, primarily represents the synergies anticipated between ALung and our ACS business. The assets acquired, including goodwill, are recognized in our ACS segment. The goodwill for the ACS reporting unit was fully impaired during the third quarter of 2022. Please refer to “Note 8. Goodwill and Intangible Assets” for further details. We recognized ALung acquisition-related expenses of approximately $5.1 million during the year ended December 31, 2022, within “Selling, general and administrative” expenses on our consolidated statement of income (loss). The Company’s consolidated financial statements include the operating results of ALung from the acquisition date. Separate post-acquisition operating results and pro forma financial information for this acquisition have not been presented as the effect was not material for disclosure purposes. The contingent consideration payments are triggered upon the achievement of thresholds associated with sales of products covered by the purchase agreement and are estimated to occur during the years reflected in the table below. The sales-based earnout was valued using projected sales from our internal strategic plan and is a Level 3 fair value measurement, which includes the following significant unobservable inputs (in thousands): ALung Acquisition Fair value at May 2, 2022 Valuation Technique Unobservable Input Ranges Sales-based earnout $ 16,791 Monte Carlo simulation Risk-adjusted discount rate 7.0% - 8.4% Credit risk discount rate 6.4% - 8.0% Revenue volatility 25.7% Projected years of earnout 2023 - 2027 For a reconciliation of the beginning and ending balance of contingent consideration liabilities refer to “Note 10. Fair Value Measurements.”

Divestiture of Heart Valve Busi

Divestiture of Heart Valve Business	12 Months Ended
	Dec. 31, 2022
Discontinued Operations and Disposal Groups [Abstract]
Divestiture of Heart Valve Business	Note 5. Divestiture of Heart Valve Business On December 2, 2020, LivaNova entered into a Purchase Agreement with Mitral Holdco S.à r.l. (“Mitral”), a company incorporated under the laws of Luxembourg and wholly-owned and controlled by funds advised by Gyrus Capital S.A., a Swiss private equity firm. The Purchase Agreement provided for the divestiture of certain of LivaNova’s subsidiaries as well as certain other assets and liabilities relating to the Company’s Heart Valve business and site management operations conducted by the Company’s subsidiary LSM at the Company’s Saluggia campus for $64.1 million. On April 9, 2021, LivaNova and the Purchaser entered into an Amended & Restated Purchase Agreement to, among other things, defer the closing of the sale and purchase of LSM by up to two years and include or amend certain additional terms relating to such deferral, including certain amendments relating to the potential hazardous substances liabilities of LSM and the related expense reimbursement provisions. As a result of entering into the Purchase Agreement, during the fourth quarter of 2020 the Company concluded that the assets and liabilities of the Heart Valve business being sold met the criteria to be classified as held for sale. As a result, we recognized an impairment of $180.2 million during the fourth quarter of 2020 to record the Heart Valves disposal group at fair value less estimated cost to sell. Additionally, we recorded a $21.3 million impairment to the goodwill allocated to the Heart Valves disposal group based upon the relative fair values of the businesses within Other. The sale of the Heart Valve business closed on June 1, 2021. We received $45.5 million in 2021, and the remaining deferred purchase price of $9.5 million in 2022. Also, in 2022, we made a $4.8 million payment to Mitral upon finalizing the trade working capital and net indebtedness adjustments. During the year ended December 31, 2021, we recognized a loss from the sale of the Heart Valve business of $1.9 million, which is included within other operating expenses on the consolidated statements of income (loss). In conjunction with the sale, we entered into a transition services agreement to provide certain support services generally for up to twelve months from the closing date of the sale. These services include, among others, accounting, information technology, human resources, quality assurance, regulatory affairs, supply chain, clinical affairs and customer support. During the year ended December 31, 2021, we recognized income of $1.9 million, 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 consolidated statements of income (loss).

Restructuring

Restructuring	12 Months Ended
	Dec. 31, 2022
Restructuring and Related Activities [Abstract]
Restructuring	Note 6. Restructuring We initiate restructuring plans to leverage economies of scale, streamline distribution and logistics, and strengthen operational and administrative effectiveness in order to reduce overall costs. During the fourth quarter of 2020, we initiated a reorganization plan (the “2020 Plan”) to reduce our cost structure. We incurred restructuring expenses of $5.3 million during the year ended December 31, 2020 primarily associated with severance costs for 54 employees, and $9.7 million during 2021, primarily associated with severance costs for 27 additional employees during 2021 under the 2020 Plan and lease abandonment costs. The 2020 Plan was completed during 2022. During the second quarter of 2022, management committed to implement a cost-optimization and cost reduction program to adapt to current economic conditions, which includes a workforce reduction to be completed by mid-2023. We recognized restructuring expense of $6.6 million during the year ended December 31, 2022. The total estimated restructuring costs associated with the plan are approximately $10.0 million including employee termination benefits, consulting fees and contract termination costs. The following table presents a reconciliation of the beginning and ending balance of the accruals and other reserves recorded in connection with our restructuring plans included within accrued liabilities and other long-term liabilities on the consolidated balance sheet for the years ended December 31, 2022, 2021 and 2020 (in thousands): Employee Severance and Other Termination Costs Other Total As of December 31, 2019 $ 4,097 $ 1,400 $ 5,497 Charges 7,571 — 7,571 Cash payments (5,919) (854) (6,773) As of December 31, 2020 5,749 546 6,295 Charges 7,963 1,750 9,713 Cash payments (12,876) (2,296) (15,172) As of December 31, 2021 836 — 836 Charges 6,611 — 6,611 Cash payments (5,402) — (5,402) As of December 31, 2022 (1) $ 2,045 $ — $ 2,045 (1) Cumulative restructuring expense, inclusive of discontinued operations, since the merger of Cyberonics, Inc. and Sorin S.p.A. (“Sorin”) in October 2015 totaled $135.4 million as of December 31, 2022. The following table presents restructuring expense by reportable segment for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary $ 697 $ 2,844 $ 1,040 Neuromodulation 2,651 1,531 3,223 Advanced Circulatory Support 1,999 — — Other 1,264 5,338 3,308 Total (1) $ 6,611 $ 9,713 $ 7,571 (1) Restructuring expense is included within other operating expenses on the consolidated statements of income (loss).

Product Remediation Liability

Product Remediation Liability	12 Months Ended
	Dec. 31, 2022
Loss Contingency [Abstract]
Product Remediation Liability	Note 7. 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 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. On December 31, 2016, we recognized a liability for a product remediation plan related to our 3T device. The remediation plan consisted 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 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. In April 2017, we obtained CE Mark in Europe for the design change of the 3T device, and in October 2018, the FDA concluded that we could commence the vacuum canister and internal sealing upgrade program in the U.S. On February 25, 2020, LivaNova received clearance for K191402, a 510(k) for the 3T devices that addressed issues contained in the 2015 Warning Letter along with design changes that further mitigate the potential risk of aerosolization. Concurrent with this clearance, (1) 3T devices manufactured in accordance with K191402 will not be subjected to the import alert and (2) LivaNova initiated a correction to distribute the updated Operating Instructions cleared under K191402. In December 2022, we received a close-out letter from the FDA for the Warning Letter the Company received on December 29, 2015. Closure of the 2015 Warning Letter represents the culmination of LivaNova’s corrective actions implemented at its Munich manufacturing facility and to the 3T Heater-Cooler device design. The following table presents the changes in the product remediation liability for the years ended December 31, 2022, 2021 and 2020 (in thousands): As of December 31, 2019 $ 3,251 Adjustments 3,199 Remediation activity (5,743) Effect of changes in foreign currency exchange rates 349 As of December 31, 2020 1,056 Adjustments 712 Remediation activity (880) Effect of changes in foreign currency exchange rates (81) As of December 31, 2021 807 Remediation activity (15) Effect of changes in foreign currency exchange rates (47) As of December 31, 2022 $ 745

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Note 8. Goodwill and Intangible Assets The following table presents our finite-lived and indefinite-lived intangible assets as of December 31, 2022 and 2021 (in thousands): 2022 2021 Finite-lived intangible assets: Customer relationships $ 184,397 $ 192,800 Developed technology 217,205 219,706 Trade names 24,368 25,154 Other intangible assets 756 616 Total gross finite-lived intangible assets 426,726 438,276 Accumulated amortization - Customer relationships 72,820 65,106 Accumulated amortization - Developed technology 80,219 68,488 Accumulated amortization - Trade names 16,483 16,500 Accumulated amortization - Other intangible assets 651 506 Total accumulated amortization 170,173 150,600 Net finite-lived intangible assets $ 256,553 $ 287,676 Indefinite-lived intangible assets: IPR&D $ 112,006 $ 112,006 Goodwill 768,787 899,525 Total indefinite-lived intangible assets $ 880,793 $ 1,011,531 The following table presents the amortization periods for our finite-lived intangible assets as of December 31, 2022: Minimum Life in years Maximum Life in years Customer relationships 8 18 Developed technology 14 17 Trade names 15 15 The following table presents the estimated future amortization expense based on our finite-lived intangible assets as of December 31, 2022 (in thousands): 2023 $ 25,372 2024 25,372 2025 25,372 2026 25,372 2027 24,957 Thereafter 130,108 Total $ 256,553 Goodwill The following table presents the changes in the carrying amount of goodwill by reportable segment for the years ended December 31, 2022, 2021 and 2020 (in thousands): Cardiopulmonary Neuromodulation Advanced Circulatory Support Other (1) Total As of December 31, 2019 $ 394,735 $ 398,754 $ 102,526 $ 19,779 $ 915,794 Impairment (2) — — — (21,269) (21,269) Foreign currency adjustments 26,303 — — 1,490 27,793 As of December 31, 2020 421,038 398,754 102,526 — 922,318 Foreign currency adjustments (22,793) — — — (22,793) As of December 31, 2021 398,245 398,754 102,526 — 899,525 Goodwill as a result of acquisition (3) — — 25,893 — 25,893 Measurement period adjustments — — 977 — 977 Impairment (4) — — (129,396) — (129,396) Foreign currency adjustments (28,212) — — — (28,212) As of December 31, 2022 $ 370,033 $ 398,754 $ — $ — $ 768,787 (1) Other includes goodwill associated the Company’s Heart Valve business, which was divested on June 1, 2021. (2) During the year ended December 31, 2020, the Company recognized a $21.3 million impairment of goodwill allocated to Heart Valves. Refer to “Note 5. Divestiture of Heart Valve Business” for additional information. (3) Refer to “Note 4. Business Combinations” for additional information. (4) During the year ended December 31, 2022, the Company recognized a $129.4 million impairment of goodwill associated with the Company’s ACS business. On December 2, 2020, LivaNova entered into a Purchase Agreement for the divestiture of certain of LivaNova’s subsidiaries as well as certain other assets and liabilities relating to the Company’s Heart Valve business. We performed a quantitative assessment as of December 2, 2020 of the goodwill associated with the previously reported Cardiovascular reporting unit and concluded that the goodwill was not impaired. We then allocated $21.3 million of the previously reported Cardiovascular goodwill to the Heart Valves disposal group based on the relative fair values of the businesses within the previously reported Cardiovascular reporting unit and recognized a $21.3 million impairment to the allocated goodwill. For additional information refer to “Note 5. Divestiture of Heart Valve Business.” As part of our third-quarter 2022 goodwill impairment assessment, we considered that revenue for our ACS reporting unit during the nine months ended September 30, 2022, had declined by approximately 29% compared to the prior year period, primarily as a result of a reduction in severe COVID-19 cases, hospital-related challenges and product mix. Furthermore, future revenue projections were reduced. Based on these circumstances, we concluded it was more likely than not that the goodwill of our ACS reporting unit was impaired, and we performed a quantitative assessment of the goodwill as of September 30, 2022, using management’s then current estimate of future cash flows. Based on the valuation performed, we determined that the fair value of the ACS reporting unit was less than the carrying value and recognized a goodwill impairment of $129.4 million in our consolidated statements of income (loss) during the year ended December 31, 2022. We performed a quantitative assessment for our Cardiopulmonary and Neuromodulation reporting units as of October 1, 2022. The quantitative impairment assessment was performed using management’s current estimate of future cash flows. We concluded that the fair value of our Cardiopulmonary and Neuromodulation reporting units exceeded the carrying value of the respective reporting units by 32% and 467%, respectively. Therefore, we concluded that our Cardiopulmonary and Neuromodulation reporting units’ goodwill was not impaired on the October 1, 2022 test date. Cumulative goodwill impairments from continuing operations since the merger of Cyberonics, Inc. and Sorin in October 2015 totaled $193.1 million as of December 31, 2022.

Investments

Investments	12 Months Ended
	Dec. 31, 2022
Investments [Abstract]
Investments	Note 9. Investments The following table presents the carrying value of our investments in equity securities of non-consolidated affiliates without readily determinable fair values and an investment accounted for under the equity method. Investments, excluding the equity method investment, 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 below equity investments are included in investments on the consolidated balance sheets as of December 31, 2022 and 2021 (in thousands): 2022 2021 ShiraTronics, Inc. $ 5,000 $ 3,331 Noctrix Health, Inc. 3,159 3,159 Ceribell, Inc. 3,000 3,000 MD Start II (1) 1,069 1,135 Rainbow Medical Ltd. 1,047 1,111 Highlife S.A.S. 1,013 1,075 ALung Technologies, Inc. (2) — 3,000 14,288 15,811 Equity method investment (3) 1,978 787 $ 16,266 $ 16,598 (1) During the second quarter of 2021 the Company received a cash dividend from its investment in MD Start II of $3.1 million, which is included in “Foreign exchange and other income/(expense)” on the consolidated statements of income (loss) for the year ended December 31, 2022. (2) As of December 31, 2021, LivaNova owned a 3% equity interest in ALung with a carrying value of $3.0 million, as well as held a note receivable due from ALung with a carrying value of $2.5 million. On May 2, 2022, we acquired the remaining 97% of equity interests in ALung. Please refer to “Note 4. Business Combinations” for further details. (3) As of December 31, 2022, we are required to fund follow-on investments up to approximately €3.0 million (approximately $3.2 million as of December 31, 2022) based on cash calls.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 10. 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 years ended December 31, 2022, 2021 or 2020. Assets and Liabilities Measured at Fair Value on a Recurring Basis The following tables present information by level for assets and liabilities that are measured at fair value on a recurring basis as of December 31, 2022 and 2021 (in thousands): 2022 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets Derivative assets - designated as cash flow hedges (interest rate swaps) $ 1,333 $ — $ 1,333 $ — Derivative assets - capped call derivatives 54,393 — — 54,393 Convertible notes receivable 285 — — 285 $ 56,011 $ — $ 1,333 $ 54,678 Liabilities Derivative liabilities - freestanding instruments (foreign currency exchange rate “ FX ” ) $ 5,886 $ — $ 5,886 $ — Derivative liabilities - embedded exchange feature 85,675 — — 85,675 Contingent consideration arrangements 85,292 — — 85,292 $ 176,853 $ — $ 5,886 $ 170,967 2021 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets Derivative assets - designated as cash flow hedges (FX) $ 243 $ — $ 243 $ — Derivative assets - freestanding instruments (FX) 61 — 61 — Derivative assets - capped call derivatives 106,629 — — 106,629 Convertible notes receivable 2,767 — — 2,767 $ 109,700 $ — $ 304 $ 109,396 Liabilities Derivative liabilities - designated as cash flow hedges (FX) $ 1,286 $ — $ 1,286 $ — Derivative liabilities - freestanding instruments (FX) 427 — 427 — Derivative liabilities - embedded exchange feature 181,700 — — 181,700 Contingent consideration arrangements 98,382 — — 98,382 $ 281,795 $ — $ 1,713 $ 280,082 The following table presents a reconciliation of the beginning and ending balances of our recurring fair value measurements, using significant unobservable inputs (Level 3) for the years ended December 31, 2022, 2021 and 2020 (in thousands): Capped Call Derivative Asset Convertible Notes Receivable Embedded Exchange Feature Derivative Liability Other Derivative Liabilities Contingent Consideration Liability Arrangements As of December 31, 2020 $ 72,302 $ 2,775 $ 121,756 $ 4,290 $ 103,818 Payments (1) — — — — (6,000) Changes in fair value (2) (3) 34,327 (8) 59,944 (4,290) 564 As of December 31, 2021 106,629 2,767 181,700 — 98,382 Additions — — — — 26,369 Utilized as business combination consideration — (2,495) — — — Measurement period adjustments (4) — — — — (9,578) Changes in fair value (2) (3) (5) (52,236) 13 (96,025) — (29,881) As of December 31, 2022 - long-term $ 54,393 $ 285 $ 85,675 $ — $ 85,292 (1) During the year ended December 31, 2021, we paid $6.0 million under the contingent consideration arrangement for the acquisition of Miami Instruments, LLC. (2) During the year ended December 31, 2022, the contingent consideration change in fair value resulted in a decrease of $10.5 million recorded to cost of sales R&D cost of sales R&D (3) Changes in the fair value of the embedded exchange feature derivative, capped call derivatives and other derivative liabilities are recognized in foreign exchange and other income/(expense) in the consolidated statements of income (loss). See the below section titled “ Embedded Exchange Feature and Capped Call Derivatives” for further information on the changes in fair value as it relates to the embedded exchange feature and capped call derivatives. (4) For further details refer to “Note 4. Business Combinations.” (5) The decrease in fair value associated with contingent consideration arrangements during the year ended December 31, 2022 was primarily related to the change in (i) the discount rates due to increasing interest rates, (ii) the probability of the regulatory milestone-based payment associated with the acquisition of TandemLife and (iii) the timing of projected achievement of a certain regulatory milestone and timing of sales-based earnout payments associated with the acquisition of ImThera. Embedded Exchange Feature and Capped Call Derivatives In June 2020, the Company issued $287.5 million in cash exchangeable senior notes and entered into related capped call transactions. The cash exchangeable senior notes include an embedded exchange feature that is bifurcated from the cash exchangeable senior notes. Please refer to “Note 11. Financing Arrangements” for further details. The embedded exchange feature derivative is measured at fair value using a binomial lattice model and discounted cash flows that utilize observable and unobservable market data. The capped call derivative is measured at fair value using the Black-Scholes model utilizing observable and unobservable market data, including stock price, remaining contractual term, expected volatility, risk-free interest rate and expected dividend yield, as applicable. The embedded exchange feature and capped call derivatives are classified as Level 3 as the Company uses historical volatility and implied volatility from options traded to determine expected stock price volatility, an unobservable input that is significant to the valuation. In general, an increase in our stock price or stock price volatility would increase the fair value of the embedded exchange feature and capped call derivatives which would result in an increase in expense. As time to the expiration of the derivatives decreases, the fair value of the derivatives would decrease. The future impact on net income depends on how significant inputs such as stock price, stock price volatility and time to the expiration of the derivatives change in relation to other inputs. Changes in the fair value of the embedded exchange feature derivative and capped call derivatives are recognized in foreign exchange and other income/(expense) in the consolidated statements of income (loss). The fair value of the embedded exchange feature derivative liability and the capped call derivative assets were $85.7 million and $54.4 million , respectively, as of December 31, 2022, and the stock price volatility was 43%. As of December 31, 2022, a 10% lower volatility, holding other inputs constant, would result in approximate fair value for the embedded exchange feature derivative of $70.6 million and a 10% higher volatility, holding other inputs constant, would result in approximate fair value of $100.3 million. As of December 31, 2022, a 10% lower volatility, holding other inputs constant would result in approximate fair value for the capped call derivatives of $52.1 million and a 10% higher volatility, holding other inputs constant, would result in approximate fair value of $53.7 million. Contingent Consideration Arrangements The following table presents the fair value of our Level 3 contingent consideration arrangements by acquisition as of December 31, 2022 and 2021 (in thousands): 2022 2021 ImThera $ 69,389 $ 86,830 ALung 15,903 — TandemLife — 11,552 $ 85,292 $ 98,382 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. The sales-based earnout is valued using projected sales from our internal strategic plan. These arrangements are Level 3 fair value measurements and include the following significant unobservable inputs as of December 31, 2022: ImThera Acquisition Valuation Technique Unobservable Input Inputs Regulatory milestone-based payment Discounted cash flow Discount rate 10.5% Probability of payment 85% Projected payment year 2025 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 14.3% - 14.6% Credit risk discount rate 10.8% - 11.4% Revenue volatility 32.5% Probability of payment 85% Projected years of earnout 2026 - 2029 The ALung business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain sales-based thresholds associated with sales of products. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs as of December 31, 2022: ALung Acquisition Valuation Technique Unobservable Input Inputs Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 9.7% - 10.3% Credit risk discount rate 10.0% - 11.1% Revenue volatility 28.9% Projected years of earnout 2023 - 2027 The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The probability of payment for the final regulatory milestone was reduced to 0% during the year ended December 31, 2022. Assets and Liabilities Measured at Fair Value on a Nonrecurring Basis Our investments in equity securities of non-consolidated affiliates without readily determinable fair values 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. Our investments in non-financial assets such as, goodwill, intangible assets, and PP&E, are measured at fair value if there is an indication of impairment and recorded at fair value only when an impairment is recognized. We classify the measurement input for these assets as Level 3 inputs within the fair value hierarchy. Other The carrying values of our cash, cash equivalents and restricted cash, accounts receivable, accounts payable and accrued liabilities approximate their fair values due to the short-term nature of these items. The carrying value of our long-term debt including the current portion, as of December 31, 2022, was $539.0 million. The fair value of our 2020 Cash Exchangeable Senior Notes (the “Notes”) as of December 31, 2022, and 2021 was $328.1 million

Financing Arrangements

Financing Arrangements	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Financing Arrangements	Note 11. Financing Arrangements The following table presents the outstanding principal amounts of our long-term debt facilities as of December 31, 2022 and 2021 (in thousands, except interest rates): 2022 2021 Maturity Interest Rate Term Facilities $ 289,294 $ — July 2027 7.21% 2020 Cash Exchangeable Senior Notes 239,568 225,140 December 2025 3.00% Bank of America Merrill Lynch Banco Múltiplo S.A. 6,462 6,113 July 2023 16.20% Mediocredito Italiano 1,601 3,379 December 2023 0.50% - 3.47% Bank of America, U.S. 1,500 1,500 January 2023 5.45% Other 534 663 Total long-term facilities 538,959 236,795 Less current portion of long-term debt 20,892 226,946 Total long-term debt obligations $ 518,067 $ 9,849 The following table presents the contractual annual principal maturities of our long-term debt facilities as of December 31, 2022 (in thousands): 2023 $ 20,914 2024 15,092 2025 306,301 2026 26,310 2027 226,875 Thereafter 252 Total payments 595,744 Less: Debt issuance costs (56,785) Total long-term facilities $ 538,959 Revolving Credit The outstanding principal amount of our short-term unsecured revolving credit agreements and other agreements with various banks was $2.5 million and $2.7 million as of December 31, 2022 and 2021, respectively, with interest rates ranging from 4.24% to 16.35% and loan terms ranging from overnight to 365 days. On August 13, 2021, LivaNova PLC and its wholly-owned subsidiary, the Borrower, entered into a First Lien Credit Agreement with the lenders and issuing banks party thereto and Goldman Sachs Bank USA, as First Lien Administrative Agent and First Lien Collateral Agent, relating to a $125 million 2021 First Lien Credit Agreement. The 2021 First Lien Credit Agreement, as amended from time to time, expires on August 13, 2026 and bears interest at a rate equal to, for U.S. dollar-denominated loans, an adjusted Secured Overnight Financing Rate (“SOFR”) with a floor of 0.00%, or a Base Rate, plus, in each case, a variable margin based on the Company’s Total Net Leverage Ratio. Interest is paid monthly or quarterly, as selected by the Borrower, with any outstanding principal due at maturity. The 2021 First Lien Credit Agreement also contemplates the payment of commitment fees on the unused portion of the commitments, at a variable percentage based on the Company’s Total Net Leverage Ratio. As of December 31, 2022 and 2021, the applicable commitment fee percentage was 0.5% and 0.25% per annum, respectively. The 2021 First Lien Credit Agreement is available for working capital and other general corporate purposes and, if drawn, can be repaid at any time without premium or penalty. As of December 31, 2022, we were in compliance with the financial covenants contained in our 2021 First Lien Credit Agreement. There were no outstanding borrowings under the 2021 First Lien Credit Agreement’s $125 million revolving credit facility as of December 31, 2022. On August 12, 2021, the Company terminated its previous $50.0 million revolving credit facility agreement with ACF FINCO I LP, which was undrawn, resulting in a loss on debt extinguishment of $1.6 million recognized during the year ended December 31, 2021 primarily associated with the write-off of unamortized debt issuance costs, and is included within loss on debt extinguishment on the consolidated statements of income (loss) . Bridge Loan Facility On February 24, 2022, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA entered into an Incremental Facility Amendment No. 1 to the 2021 First Lien Credit Agreement, relating to the €200 million Bridge Loan Facility. On March 16, 2022, LivaNova entered into Amendment No. 2 to the 2021 First Lien Credit Agreement, which converted the available borrowings under the Bridge Loan Facility from €200 million to $220 million and converted the EURIBOR rate in the 2021 First Lien Credit Agreement to SOFR. LivaNova delivered a borrowing notice for $220 million in connection with the Bridge Loan Facility, which was funded on March 17, 2022. On March 18, 2022, LivaNova PLC, acting through its Italian branch, entered into an Indemnity Letter and an Account Pledge Agreement with Barclays, further to which Barclays issued the SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. The proceeds of the Bridge Loan Facility were used by LivaNova to post a portion of the cash collateral supporting the SNIA Litigation Guarantee. Cash collateral classified as restricted cash on the consolidated balance sheet as of December 31, 2022 was $301.4 million. For additional information regarding the SNIA litigation, please refer to “Note 14. Commitments and Contingencies.” Debt discounts and issuance costs related to the Bridge Loan Facility were approximately $4.5 million. Amortization of debt discount and issuance costs for the Bridge Loan Facility was $4.5 million for the year ended December 31, 2022 and is included in interest expense on the consolidated statement of income (loss). The Bridge Loan Facility was repaid in full on July 6, 2022. Term Facilities On July 6, 2022, LivaNova and its wholly-owned subsidiary, LivaNova USA, entered into the Incremental Amendment No. 2 to its 2021 First Lien Credit Agreement. The Incremental Amendment No. 2 provides for LivaNova USA to, among other things, obtain commitments for term loan facilities from a syndicate of lenders in an aggregate principal amount of $350 million consisting of (i) the Initial Term Facility with an aggregate principal amount of $300 million and (ii) the Delayed Draw Term Facility with an additional aggregate principal amount of $50 million, which is available in one single drawing on or after July 6, 2022 until the date that is nine months after such date and, together with the Initial Term Facility, the Term Facilities. As of December 31, 2022, availability under the Delayed Draw Term Facility was $50 million. Proceeds from the Initial Term Facility were used to repay in full the Bridge Loan Facility on July 6, 2022, with the remainder used for general corporate purposes of the Company. The Term Facilities have a maturity of the earlier of (i) five years or (ii) 91 days prior to December 15, 2025, the maturity date of the 2020 Cash Exchangeable Senior Notes, unless by that date LivaNova USA will have either redeemed or refinanced the Notes, or set aside an amount of cash equal to the then-outstanding principal amount of the Notes. The Term Facilities bear interest at a rate equal to an adjusted term SOFR plus a variable margin based on the Company’s consolidated Total Net Leverage Ratio. As of December 31, 2022, the applicable margin over Adjusted SOFR was equal to 3.5% per annum. The Term Facilities are subject to an original issue discount of 1.5% of their principal amount. The Delayed Draw Term Facility also contemplates the payment of commitment fees at a variable percentage based on the Company’s Total Net Leverage Ratio. As of December 31, 2022, the applicable commitment fee percentage was equal to 0.5% per annum. The Term Facilities are subject to quarterly principal repayment, based on the following amortization schedule: (i) during the first year from the initial funding date: 1.9%; (ii) year two: 5.0%; (ii) year three: 5.0%; (iv) year four: 7.5%; and (v) year five: 10.0%, with the remainder to be paid at maturity. The effective interest rate of the Initial Term Facility as of December 31, 2022 was 6.53%. The 2021 First Lien Credit Agreement, as amended, contains customary representations, warranties and covenants, including the requirement to maintain a Senior Secured First Lien Net Leverage Ratio, calculated as the ratio of Consolidated Senior Secured First Lien Net Indebtedness to Consolidated EBITDA, as defined in the credit agreement, for the period of four consecutive fiscal quarters ended on the calculation date, of not more than 3.50 to 1.00 and an Interest Coverage Ratio, calculated as the ratio of Consolidated EBITDA to Consolidated Interest Expense, as defined in the credit agreement, for the period of four consecutive fiscal quarters ended on the calculation date, of not less than 3.00 to 1.00. As of December 31, 2022, we were in compliance with the financial covenants contained in our 2021 First Lien Credit Agreement. Debt discounts and issuance costs related to the Initial Term Facility were approximately $9.6 million. Amortization of debt discount and issuance costs for the Initial Term Facility was $0.8 million for the year ended December 31, 2022, and is included in interest expense on the consolidated statement of income (loss). The unamortized discount and issuance costs related to the Initial Term Facility as of December 31, 2022 was $10.7 million. Issuance costs related to the Delayed Draw Term Facility were approximately $1.6 million. Amortization of issuance costs for the Delayed Draw Term Facility was $1.1 million for the year ended December 31, 2022, and is included in interest expense on the consolidated statement of income (loss). The unamortized issuance cost related to the Delayed Draw Term Facility as of December 31, 2022 was $0.5 million and is included within prepaid expenses and other current assets on the consolidated balance sheet. 2020 Cash Exchangeable Senior Notes On June 17, 2020, our wholly-owned subsidiary, LivaNova USA, issued $287.5 million aggregate principal amount of 3.00% Notes by private placement to qualified institutional buyers pursuant to Rule 144A under the Securities Act of 1933, as amended. The sale of the Notes resulted in approximately $278.0 million in net proceeds to the Company after deducting issuance costs. Interest is payable semiannually in arrears on June 15 and December 15 of each year. The effective interest rate of the Notes as of December 31, 2022 was 9.95%. The Notes mature on December 15, 2025 unless earlier exchanged, repurchased, or redeemed. Debt discounts and issuance costs related to the Notes were approximately $82.0 million and included $75.0 million of discount attributable to the embedded exchange feature, discussed below, and $7.0 million of allocated issuance costs to the Notes related to legal, bank and accounting fees. Amortization of debt discount and issuance costs was $14.4 million, $13.1 million and $6.6 million for the years ended December 31, 2022, 2021 and 2020, respectively, and is included in interest expense on the consolidated statement of income (loss). The unamortized discount related to the Notes as of December 31, 2022 and 2021 was $47.9 million and $62.4 million, respectively. Holders of the Notes are entitled to exchange the Notes at any time during specified periods, at their option. This includes the right to exchange the Notes during any calendar quarter, if the last reported sale price of LivaNova’s ordinary shares, with a nominal value of £1.00 per share, is greater than or equal to 130% of the exchange price, or $79.27 per share for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter. The exchange condition was not satisfied on December 31, 2022. As a result, we have included our obligations from the Notes and the associated embedded exchange feature derivative as a long-term liability on the consolidated balance sheet as of December 31, 2022. The Notes are exchangeable solely into cash and are not exchangeable into ordinary shares of LivaNova or any other security under any circumstances. The initial exchange rate for the Notes is 16.3980 ordinary shares per $1,000 principal amount of Notes (equivalent to an initial exchange price of approximately $60.98 per share). The exchange rate is subject to adjustment in certain circumstances, as set forth in the indenture governing the Notes. The Company may redeem the Notes, at its option, on or after June 20, 2023 and prior to the 51 st scheduled trading day immediately preceding the maturity date, in whole or in part, if the last reported sale price per ordinary share has been at least 130% of the exchange price then in effect for at least 20 trading days (whether or not consecutive), including the trading day immediately preceding the date on which the Company provides notice of redemption, during any 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which the Company provides notice of redemption, at a redemption price equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. Additionally, the Company may redeem the Notes at its option, prior to their stated maturity, in whole but not in part, in connection with certain tax-related events. Embedded Exchange Feature The embedded exchange feature of the Notes requires bifurcation from the Notes and is accounted for as a derivative liability. The fair value of the Notes’ embedded exchange feature derivative at the time of issuance was $75.0 million and was recorded as debt discount on the Notes. This discount is amortized as interest expense using the effective interest method over the term of the Notes. The Notes’ embedded exchange feature derivative is carried on the consolidated balance sheets at its estimated fair value and is adjusted at the end of each reporting period, with the unrealized gain or loss reflected within foreign exchange and other income/(expense) on the consolidated statements of income (loss). The fair value of the embedded exchange feature derivative liability was $85.7 million and $181.7 million as of December 31, 2022 and 2021, respectively. Capped Call Transactions In connection with the pricing of the Notes, the Company entered into privately negotiated capped call transactions with certain of the initial purchasers of the Notes or their respective affiliates. The capped call transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the Notes, the number of LivaNova’s ordinary shares underlying the Notes, and are generally expected to offset any cash payments the Company is required to make upon exchange of the Notes in excess of the principal amount thereof in the event that the market value per ordinary share, as measured under the capped call transactions, is greater than the strike price of the capped call transactions, with such offset being subject to an initial cap price of $100.00 per share. The capped call transactions expire on December 15, 2025 and must be settled in cash. If the capped call transactions are converted or redeemed early, settlement occurs at their termination value, which is equal to their fair value at the time of the redemption. The capped call transactions are carried on the consolidated balance sheets as a derivative asset at their estimated fair value and are adjusted at the end of each reporting period, with unrealized gain or loss reflected within foreign exchange and other income/(expense) in the consolidated statements of income (loss). The fair value of the capped call derivative assets was $54.4 million and $106.6 million as of December 31, 2022 and 2021, respectively. As of December 31, 2022, the capped call derivative assets were classified as long-term. 2020 Senior Secured Term Loan The Company used the net proceeds from the 2020 senior secured term loan, together with a portion of the net proceeds of the Notes, after fees, discounts, commissions and other expenses, to repay outstanding indebtedness under the Company’s 2017 European Investment Bank loan, 2014 European Investment Bank loan, Banca Nazionale del Lavoro S.p.A loan, and 2019 Debt Facility and related expenses. The Company repaid approximately $528.0 million in aggregate outstanding principal, accrued interest and associated fees, including breakage fees and legal fees. The Company recognized a loss on debt extinguishment of $1.4 million during the year ended December 31, 2020. The loss on debt extinguishment was recognized in foreign exchange and other income/(expense) in the consolidated statements of income (loss). The remainder of the proceeds from the concurrent financing transactions were used to pay the cost of capped call transactions and for general corporate purposes. On August 12, 2021, the Company repaid in full and terminated its previously outstanding $450 million 2020 senior secured term loan, resulting in a loss on debt extinguishment of $58.6 million recognized during the year ended December 31, 2021 , which is comprised of a $35.6 million make-whole premium and $23.0 million associated with the write-off of unamortized debt issuance costs, and is included within loss on debt extinguishment on the consolidated statements of income (loss) . For additional in formation, please refer to “Note 15. Stockholders' Equity.”

Derivatives and Risk Management

Derivatives and Risk Management	12 Months Ended
	Dec. 31, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives and Risk Management	Note 12. Derivatives and Risk Management Due to the global nature of our operations, we are exposed to foreign currency exchange rate fluctuations. Historically, we have entered into FX derivative contracts and interest rate swap contracts to reduce the impact of foreign currency exchange rate and interest rate fluctuations, respectively, on earnings and cash flow. We are also exposed to equity price risk in connection with our Notes, including exchange and settlement provisions based on the price of our ordinary shares at exchange or maturity of the Notes. In addition, the capped call transactions associated with the Notes also include settlement provisions that are based on the price of our ordinary shares, subject to a capped price per share. We do not enter into derivative contracts for speculative purposes. We measure all outstanding derivatives each period end at fair value and report the fair value as either financial assets or liabilities on the consolidated balance sheets. 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, changes in the fair value of the derivative will be recorded in AOCI until the hedged item is recognized in earnings upon settlement/termination. FX derivative gains and losses in AOCI are reclassified to our consolidated statements of income (loss) as shown in the tables below, and interest rate swap gains and losses in AOCI are reclassified to interest expense on our consolidated statements of income (loss). We evaluate hedge effectiveness at inception. Cash flows from derivative contracts are reported as operating activities on our consolidated statements of cash flows. Freestanding FX Derivative Contracts The gross notional amount of FX derivative contracts not designated as hedging instruments outstanding as of December 31, 2022 and 2021 was $154.5 million and $136.7 million, respectively. These derivative contracts are designed to offset the FX effects in earnings of various intercompany loans and trade receivables. We recorded net gains (losses) for these freestanding derivatives of $4.5 million, $10.9 million and $(16.6) million for the years ended December 31, 2022, 2021 and 2020, respectively. These gains and (losses) are included in foreign exchange and other income/(expense) on our consolidated statements of income (loss). Counterparty Credit Risk We are exposed to credit risk in the event of non-performance by the counterparties to our derivatives. The two counterparties to the capped call transactions are financial institutions. To limit our credit risk, we selected financial institutions with a minimum long-term investment grade credit rating. Our exposure to the credit risk of the counterparties is not secured by any collateral. If a counterparty becomes subject to insolvency proceedings, we will become an unsecured creditor in those proceedings, with a claim equal to our exposure at that time under the capped call transactions with that counterparty. To manage credit risk with respect to our other derivatives, the Company selects and periodically reviews counterparties based on credit ratings, limits its exposure with respect to each counterparty, and monitors the market positions. However, if one or more of these counterparties were in a liability position to the Company and were unable to meet their obligations, any transactions with the counterparty could be subject to early termination, which could result in substantial losses for the Company. Cash Flow Hedges Foreign Currency Risk Historically, we have utilized FX derivative contracts, designed as cash flow hedges, to hedge the variability of cash flows associated with our 12-month U.S. dollar forecasts of revenues and costs denominated in British Pound, Japanese Yen and the Euro. We transfer to earnings from AOCI the gain or loss realized on the FX derivative contracts at the time of invoicing. Upon the settlement of our foreign currency cash flow hedges in the fourth quarter of 2022 and following an in-depth analysis of the utility of our cash flow hedging program, we discontinued our foreign currency cash flow hedging program. Interest Rate Risk We entered into interest rate swaps, which qualify for and are designated as cash flow hedges, for a notional amount covering 70% of the Initial Term Facility’s outstanding principal through April 2023, in order to minimize the impact of changes in interest rates by swapping a portion of the Initial Term Facility’s floating-rate interest payments for fixed-rate interest payments. The Initial Term Facility matures in July 2027. The following table presents the gross notional amounts of open derivative contracts designated as cash flow hedges as of December 31, 2022 and 2021 (in thousands): Description of Derivative Contract 2022 2021 FX derivative contracts to be exchanged for British Pounds $ — $ 11,160 FX derivative contracts to be exchanged for Japanese Yen — 6,648 FX derivative contracts to be exchanged for Euros — 58,224 Interest rate swap contracts 210,000 — $ 210,000 $ 76,032 The following table presents the after-tax net (loss) gain 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 12 months as of December 31, 2022 (in thousands): Description of Derivative Contract After-tax Net Gain in AOCI After-tax Net Gain Expected to be Reclassified to Earnings in Next 12 Months Interest rate swap contracts $ 966 $ 966 The following tables present the pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in OCI and the amount reclassified to earnings from AOCI for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss (Loss) Gain Recognized in OCI Loss Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other income/(expense) $ (4,602) $ (382) FX derivative contracts SG&A — (5,165) Interest rate swap contracts Interest expense 914 (52) $ (3,688) $ (5,599) 2021 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Loss Recognized in OCI (Loss) Gain Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other income/(expense) $ (3,922) $ (2,333) FX derivative contracts SG&A — 2,408 $ (3,922) $ 75 2020 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gain Recognized in OCI (Loss) Gain Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other income/(expense) $ 1,724 $ (1,522) FX derivative contracts SG&A — 980 Interest rate swap contracts Interest expense — (113) $ 1,724 $ (655) We offset fair value amounts associated with our derivative instruments on our consolidated balance sheets that are executed with the same counterparty under master netting arrangements. Our netting arrangements include a right to set off or net together purchases and sales of similar products in the settlement process. The following tables present the fair value and the location of derivative contracts reported on the consolidated balance sheets as of December 31, 2022 and 2021 (in thousands): 2022 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 Current derivative assets $ 1,333 Total derivatives designated as hedging instruments 1,333 Derivatives Not Designated as Hedging Instruments FX derivative contracts Current derivative liabilities $ 5,886 Capped call derivatives Long-term derivative assets 54,393 Embedded exchange feature Long-term derivative liabilities 85,675 Total derivatives not designated as hedging instruments 54,393 91,561 Total derivatives $ 55,726 $ 91,561 2021 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) FX derivative contracts Current derivative liabilities $ 243 Current derivative liabilities $ 1,286 Total derivatives designated as hedging instruments 243 1,286 Derivatives Not Designated as Hedging Instruments FX derivative contracts Current derivative liabilities 61 Current derivative liabilities 427 Capped call derivatives Current derivative assets 106,629 Embedded exchange feature Current derivative liabilities 181,700 Total derivatives not designated as hedging instruments 106,690 182,127 Total derivatives $ 106,933 $ 183,413 (1) For the classification of inputs used to evaluate the fair value of our derivatives, refer to “Note 10. Fair Value Measurements.”

Leases

Leases	12 Months Ended
	Dec. 31, 2022
Leases [Abstract]
Leases	Note 13. Leases We have operating leases primarily for (i) office space, (ii) manufacturing, warehouse and R&D facilities and (iii) vehicles. Our leases have remaining lease terms up to 12 years, some of which include options to extend the leases, and some of which include options to terminate the leases at our sole discretion. The following table presents the components of operating lease assets and liabilities as of December 31, 2022 and 2021 (in thousands): 2022 2021 Assets Operating lease right-of-use assets $ 35,830 $ 40,600 Liabilities Accrued liabilities and other $ 9,379 $ 11,261 Long-term operating lease liabilities 29,548 35,919 Total lease liabilities $ 38,927 $ 47,180 The following table presents the components of operating lease cost for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Operating lease cost $ 10,408 $ 18,070 $ 14,156 Variable lease cost 580 1,200 1,097 Short-term lease cost 468 1,084 415 Total lease cost $ 11,456 $ 20,354 $ 15,668 The following table presents the contractual maturities of our lease liabilities as of December 31, 2022 (in thousands): 2023 $ 10,520 2024 8,095 2025 5,372 2026 3,998 2027 3,570 Thereafter 12,747 Total lease payments 44,302 Less: Amount representing interest 5,375 Present value of lease liabilities $ 38,927 The following table presents the weighted average remaining lease term and discount rate as of December 31, 2022 and 2021: 2022 2021 Weighted Average Remaining Lease Term 6.5 years 5.8 years Weighted Average Discount Rate 3.9% 3.2% The following table presents the supplemental lease information for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 12,468 $ 13,650 $ 14,601 Operating lease assets obtained in exchange for lease liabilities $ 7,820 $ 9,037 $ 8,547

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 14. 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. We took actions to remediate the alleged violations and related inspectional observations, and on December 12, 2022, the Company received a close-out letter from the FDA, dated November 28, 2022, indicating that the FDA considers the Warning Letter closed. See “Item 1A. Risk Factors” in this Form 10-K for additional information. Saluggia Site Hazardous Substances LSM, formerly a subsidiary of Sorin, one of the companies that merged into LivaNova PLC in 2015, manages site services for the campus in Saluggia, Italy. In addition to being a former LivaNova manufacturing facility, the Saluggia campus is also the location of manufacturing facilities of third parties, a cafeteria for workers, and storage facilities for hazardous substances and equipment previously used in a nuclear research center, later turned nuclear medicine business, between the 1960s and the late 1990s. Pursuant to authorization from the Italian government, LSM has, and continues to, perform ordinary maintenance, secure the facilities, monitor air and water quality and file applicable reports with the competent environmental authorities. In 2020, LSM received correspondence from ISIN (a sub-body of the Italian Ministry of Economic Development) requesting that within five years, LSM demonstrate the financial capacity to meet its obligations under Italian law to clean and dismantle any contaminated buildings and equipment as well as to deliver hazardous substances to a national repository. This repository will be built by the Italian government at a location and time yet to be determined. ISIN subsequently published Technical Guide n. 30, which identifies the technical criteria, and general safety and protection requirements for the design, construction, operation and dismantling of temporary storage facilities for the hazardous substances. In January 2021, a list of 67 potential sites for the national repository was published. Although there is no legal obligation to begin any work or deliver the hazardous substances, as the performance of these obligations is contingent on the construction of the as-yet unbuilt national repository, based on the aforementioned factors, the Company concluded its obligation to clean, dismantle, and deliver any hazardous substances to a national repository is probable and reasonably estimable. Accordingly, in the fourth quarter of 2020, we recognized a $42.2 million provision for this matter, which is included within other operating expenses on the consolidated statements of income (loss). The estimated liability as of December 31, 2022 was $36.6 million which represented the low end of the estimated range of loss of $36.6 million to $46.6 million. The estimated liability as of December 31, 2021 was $39.3 million. The decrease in the liability from December 31, 2021 was primarily due to the effects of foreign currency changes during the year ended December 31, 2022. SNIA Environmental Liability Sorin was created as a result of a spin-off (the “Sorin spin-off”) from SNIA in 2004, and in 2015, Sorin was merged into LivaNova. SNIA subsequently became insolvent, and the Italian Ministry of the Environment and other Italian government agencies (the “Public Administrations”) sought compensation from SNIA in an aggregate amount of approximately $3.7 billion for remediation costs relating to the environmental damage at chemical sites previously operated by SNIA’s other subsidiaries. There are proceedings relating to the SNIA bankruptcy to which we are not a party in the Bankruptcy Court of Udine and the Bankruptcy Court of Milan. In 2011, the Bankruptcy Court of Udine held that 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. In 2016, the Court of Udine rejected the appeal, and the Public Administrations appealed to the Supreme Court. Similarly, in 2014, the Bankruptcy Court of Milan held that the Public Administrations were not creditors of either SNIA or its subsidiaries. The Public Administrations appealed. In April 2022, Bankruptcy Court of Milan declared the Public Administrations to be a non-privileged creditor of SNIA for up to €454 million, and the Public Administrations appealed to the Supreme Court. In 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; the Public Administrations entered voluntarily into the proceeding, asking Sorin, as jointly liable with SNIA, to pay compensation for SNIA’s environmental damages. In 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 €292,000 (approximately $312,000 as of December 31, 2022) for legal fees. The Public Administrations appealed the 2016 Decision to the Court of Appeal in Milan (“Court of Appeal”). On March 5, 2019, the Court of Appeal issued a partial decision on the merits declaring Sorin/LivaNova jointly liable with SNIA for SNIA’s environmental liabilities in an amount up to the fair value of the net worth received by Sorin because of the Sorin spin-off, an estimated €572.1 million (approximately $611.6 million as of December 31, 2022). We appealed the partial decision on liability to the Italian Supreme Court in August 2019. In November 2021, the Court of Appeal delivered the remainder of its decision, ordering LivaNova to pay damages of approximately €453.6 million (approximately $484.9 million as of December 31, 2022). We appealed the decision on damages in December 2021. On February 21, 2022, the Court of Appeal notified the Company that it granted the Company a suspension with respect to the payment of damages until a decision has been reached on the appeal to the Italian Supreme Court. This suspension was subject to our providing a first demand bank guarantee of €270.0 million (approximately $288.6 million as of December 31, 2022) within 30 calendar days, and on March 21, 2022, LivaNova delivered the guarantee, thereby satisfying the condition. Refer to “Note 11. Financing Arrangements” for information on the financing of the guarantee. In November 2022, in response to one of a number of appeals asserted by LivaNova, the Supreme Court issued an ordinance, a procedural document, whereby the Supreme Court referred a question on interpretation of a European directive on demergers to the European Court of Justice (“ECJ”). Specifically, the ordinance asks the ECJ to provide a binding decision as to whether a company resulting from a demerger can be held jointly and severally liable not only for the established liabilities of the demerged company that were articulated at the time of demerger, but also for the environmental liabilities of the demerged company that materialized after the demerger which are derived from actions performed prior to the demerger. Following receipt of the binding decision from the ECJ, the Supreme Court is expected to incorporate and issue a decision in response to all of the appeals of LivaNova and counter-appeals submitted by the Public Administrations. While the timing of the decisions by the ECJ and, subsequently, the Supreme Court are uncertain, the Company believes that the effect of the ordinance will result in a delay of any final decision until at least 2024. In 2011, Caffaro, a SNIA subsidiary, sold its Brescia chemical business to Caffaro Brescia, a third party belonging to the Todisco group, and as part of the acquisition, Caffaro Brescia agreed to secure hydraulic barriers at the site and maintain existing environmental security measures. In 2020, Caffaro Brescia declared it was withdrawing from its agreement to maintain the environmental measures. In 2021, we (in addition to Caffaro Brescia, and other non-LivaNova entities) received an administrative order (“Order”) from the Italian Ministry of the Environment requiring us to ensure the maintenance of the environmental measures and to guarantee that such works remain fully operational, the annual management and maintenance for which is estimated at approximately €1 million per year. LivaNova’s receipt of the Order appears to be based on the aforementioned Court of Appeal decision regarding our alleged joint liability with SNIA for SNIA’s environmental liabilities. Our response, dated February 16, 2021, disputes the grounds upon which the Order is based. We also appealed the Order in the Administrative Court in Brescia. We have not recognized a liability in connection with these related matters because any potential loss is not currently probable. Product Liability Litigation The Company is currently involved in litigation involving our 3T device. The litigation includes 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. On March 29, 2019, we announced a settlement framework that provides for a comprehensive resolution of the personal injury cases pending in the multi-district litigation in U.S. federal court, the related class action in federal court, as well as certain cases in state courts across the United States. The agreement, which makes no admission of liability, is subject to certain conditions, including acceptance of the settlement by individual claimants and provides for a total payment of up to $225 million to resolve the claims covered by the settlement. Per the agreed upon terms, the second and final payment of $90 million was paid into a qualified settlement fund in January 2020. Cases in state courts in the U.S. and in jurisdictions outside the U.S. continue to progress. As of February 27, 2023, including the cases encompassed in the settlement framework described above that have not yet been dismissed, we were aware of approximately 85 filed and unfiled claims worldwide, with the majority of the claims in various federal or state courts throughout the United States. This number includes two cases that have settled but have not yet been dismissed. 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 or concealment, unjust enrichment, and violations of various state consumer protection statutes. During the years ended December 31, 2022, 2021 and 2020 we recorded an additional liability of $22.3 million, $38.1 million and $3.9 million, respectively, due to new information received about the nature of certain claims. As of December 31, 2022, the provision for these matters was $32.5 million. While the amount accrued represents our best estimate for those filed and unfiled claims that we believe are both probable and estimable at this time, and which are a subset of the filed and unfiled claims worldwide of which we are currently aware, the actual liability for resolution of these matters may vary from our estimate. The remaining claims for which a provision has not been recorded are remote or the potential loss is not estimable at this time. The following table presents the changes in the carrying amount of the litigation provision liability for the years ended December 31, 2022, 2021 and 2020 (in thousands): As of December 31, 2019 $ 170,404 Payments (138,178) Adjustments (1) 3,906 FX and other 358 As of December 31, 2020 36,490 Payments (34,808) Adjustments (1) 38,068 FX and other (280) As of December 31, 2021 39,470 Payments (28,867) Adjustments (1) 22,309 FX and other (425) As of December 31, 2022 32,487 Less current portion as of December 31, 2022 29,481 Long-term portion as of December 31, 2022 (2) $ 3,006 (1) Adjustments to the litigation provision are included within other operating expenses on the consolidated statements of income (loss). (2) Included within other long-term liabilities on the consolidated balance sheet. Caisson Contract Litigation On November 25, 2019, LivaNova received notice of a lawsuit initiated by former members of Caisson, a subsidiary of the Company acquired in 2017. The lawsuit, Todd J. Mortier, as Member Representative of the former Members of Caisson Interventional, LLC v. LivaNova USA, Inc., was filed in the United States District Court for the District of Minnesota. The complaint alleged (i) breach of contract, (ii) breach of the covenant of good faith and fair dealing and (iii) unjust enrichment in connection with the Company’s operation of Caisson’s TMVR program and the Company’s November 20, 2019 announcement that it was ending the TMVR program at the end of 2019. The lawsuit sought damages arising out of the 2017 acquisition agreement, including various regulatory milestone payments. In May 2022, the District Court granted LivaNova’s motion for summary judgment; in response, Caisson filed an appeal to the Eighth Circuit Court of Appeal. We intend to vigorously defend this claim. The Company has not recognized a liability related to this matter because any potential loss is not currently probable or reasonably estimable. Mitral Demand Letter On July 29, 2022, we received a demand letter from Mitral for approximately €20.8 million ($22.2 million as of December 31, 2022) for breach of warranty claims under the A&R Purchase Agreement. Specifically, the claims allege failure to disclose certain information relating to a supplier, thereby allegedly impacting the profitability of Mitral’s business in China and Japan. We do not believe that Mitral’s claims will be sustained or that LivaNova is responsible for any alleged breach of warranty. Subject to certain exceptions, warranty claims of this type are capped at €8 million, and the amount of any such loss. The Company has not recognized a liability related to this matter because any potential loss is not currently probable. Italian MedTech Payback Measure As previously disclosed, in 2015, the Italian Parliament introduced rules regarding public contracts with the National Healthcare System for the supply of goods and services. In particular, the law introduced a “payback” measure requiring companies selling medical devices in Italy to repay a percentage of the healthcare expenditures exceeding the regional maximum caps for medical devices. In the intervening years since the rules were first issued, there has been considerable uncertainty about how the law will operate and what the exact timeline is for finalization. In August 2022, a decree was published which provided guidance and timetables for the rule, and in January 2023, the Italian government approved a decree whereby a company’s obligation to execute payback payments is suspended until April 30, 2023. We filed an appeal at the Administrative Court against the Decree of the Ministry of Health assessing the amount payable and against the MedTech Payback Guidelines, and we are preparing appeals against the regions requesting payments. The Company has accrued for the law since 2015 based on market and product information. As of December 31, 2022, the total amount reserved for this matter was $6.4 million, however, the actual liability could vary from this amount. 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	12 Months Ended
	Dec. 31, 2022
Stockholders' Equity Note [Abstract]
Stockholders' Equity	Note 15. Stockholders' Equity On August 6, 2021, the Company closed an offering and issued 4,181,818 ordinary shares, par value £1.00 per share, at an offering price of $82.50 per share. Net proceeds from the offering were approximately $322.6 million, after deducting underwriting discounts, commissions and offering expenses. Proceeds from the offering were used to repay the Company’s $450 million 2020 senior secured term loan. For additional in formation, please refer to “Note 11. Financing Arrangements.” Accumulated other comprehensive income (loss) The following table presents the change in each component of AOCI, net of tax and the reclassifications out of AOCI into net loss for the years ended December 31, 2022, 2021 and 2020 (in thousands): Change in Unrealized Gain (Loss) on Cash Flow Hedges Foreign Currency Translation Adjustments (1) Total As of December 31, 2019 $ 513 $ (19,905) $ (19,392) Other comprehensive income before reclassifications, before tax 1,724 45,395 47,119 Tax expense (415) — (415) Other comprehensive income before reclassifications, net of tax 1,309 45,395 46,704 Reclassification of loss from accumulated other comprehensive income (loss), before tax 655 — 655 Reclassification of tax benefit (158) — (158) Reclassification of loss from accumulated other comprehensive income (loss), after tax 497 — 497 Net current-period other comprehensive income, net of tax 1,806 45,395 47,201 As of December 31, 2020 2,319 25,490 27,809 Other comprehensive loss before reclassifications, before tax (3,922) (31,722) (35,644) Tax benefit 719 — 719 Other comprehensive loss before reclassifications, net of tax (3,203) (31,722) (34,925) Reclassification of gain from accumulated other comprehensive income (loss), before tax (75) — (75) Reclassification of tax expense 14 — 14 Reclassification of gain from accumulated other comprehensive income (loss), after tax (61) — (61) Net current-period other comprehensive loss, net of tax (3,264) (31,722) (34,986) As of December 31, 2021 (945) (6,232) (7,177) Other comprehensive income before reclassifications, before tax (3,688) (42,853) (46,541) Tax benefit — — — Other comprehensive income before reclassifications, net of tax (3,688) (42,853) (46,541) Reclassification of gain from accumulated other comprehensive income (loss), before tax 5,599 — 5,599 Reclassification of tax expense — — — Reclassification of gain from accumulated other comprehensive income (loss), after tax 5,599 — 5,599 Net current-period other comprehensive income (loss), net of tax 1,911 (42,853) (40,942) As of December 31, 2022 $ 966 $ (49,085) $ (48,119)

Stock-Based Plans

Stock-Based Plans	12 Months Ended
	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Stock-Based Plans	Note 16. Stock-Based Plans Stock-Based Plans Stock-based awards may be granted under the 2015 Incentive Award Plan (the “2015 Plan”) and the 2022 Incentive Award Plan (the “2022 Plan”) in the form of stock options, SARs, RSUs and other stock-based and cash-based awards. As of December 31, 2022, there were approximately 317,200 shares available for future grants to our Non-Executive Directors under the 2015 Plan and 1,900,000 shares pursuant to Options or Stock Appreciation Rights and 1,137,785 shares pursuant to other types of awards available for future grants to our employees under the 2022 Plan. During the year ended December 31, 2022, we issued stock-based compensatory awards with terms approved by the Compensation Committee of our Board of Directors. The awards with service conditions generally vest ratably from two invested capital operating performance-based awards that were issued cliff vest after three years subject to the achievement of certain thresholds of cumulative results for those metrics for the three-year period ending December 31, 2024. The Company also provides a Global Employee Share Purchase Plan (“ESPP”). Compensation expense related to the ESPP for the years ended December 31, 2022, 2021 and 2020 was $1.2 million, $1.5 million and $1.2 million, respectively. Stock-Based Compensation The following table presents the amounts of stock-based compensation recognized on our consolidated statements of income (loss), by expense category for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cost of goods sold $ 1,455 $ 2,451 $ 1,898 Selling, general and administrative 35,638 29,449 29,661 Research and development 7,716 8,664 3,530 Total stock-based compensation expense 44,809 40,564 35,089 Income tax benefit 706 588 992 Total expense, net of income tax benefit $ 44,103 $ 39,976 $ 34,097 The following table presents the amounts of stock-based compensation expense recognized on our consolidated statements of income (loss) by type of arrangement for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Service-based restricted stock units $ 21,563 $ 19,614 $ 18,320 Service-based stock appreciation rights 14,065 12,489 12,715 Market performance-based restricted stock units 4,651 3,522 3,200 Operating performance-based restricted stock units 3,338 3,434 (370) Employee stock purchase plan 1,192 1,505 1,224 Total stock-based compensation expense $ 44,809 $ 40,564 $ 35,089 Unrecognized Stock-Based Compensation The following table presents the amounts of stock-based compensation cost not yet recognized related to non-vested awards, including awards assumed or issued as of December 31, 2022 (in thousands): Unrecognized Compensation Cost Weighted Average Remaining Vesting Period (in years) Service-based stock appreciation rights $ 25,886 2.61 Service-based restricted stock unit awards 33,823 2.49 Performance-based restricted stock unit awards 9,922 1.74 Total stock-based compensation cost unrecognized $ 69,631 2.28 Stock Appreciation Rights and Stock Options We use the Black-Scholes option pricing methodology to calculate the grant date fair market value of SARs. The following table lists the assumptions we utilized as inputs to the Black-Scholes model for the years ended December 31, 2022, 2021 and 2020: 2022 2021 2020 Dividend yield (1) — — — Risk-free interest rate (2) 2.5% 1.0% 0.4% Expected option term - in years (3) 5.3 5.6 5.4 Expected volatility at grant date (4) 42.2% 42.1% 39.5% (1) We have not paid dividends and no future dividends have been approved. (2) We use yield rates on U.S. Treasury securities for a period that approximates the expected term of the awards granted to estimate the risk-free interest rate. (3) We estimated the expected term of the awards granted using historic data of actual time elapsed between the date of grant and the exercise or forfeiture of options or SARs for employees. (4) We determine the expected volatility of the awards based on historical volatility. The following tables present the activity for service-based SARs and stock option awards: SARs and Stock Options Number of Optioned Shares Wtd. Avg. Exercise Price per Share Wtd. Avg. Remaining Contractual Term (years) Aggregate Intrinsic Value (in thousands) (1) Outstanding — as of December 31, 2021 2,634,373 $ 65.94 Granted 553,050 $ 82.04 Exercised (93,191) $ 48.86 Forfeited (150,881) $ 67.46 Expired (136,515) $ 89.41 Outstanding — as of December 31, 2022 2,806,836 $ 68.46 6.67 $ 10,070 Fully vested and exercisable — end of year 1,460,162 $ 67.43 5.24 $ 5,494 Fully vested and expected to vest — end of year (2) 2,756,467 $ 68.35 6.64 $ 9,979 (1) The aggregate intrinsic value of SARs and options is based on the difference between the fair market value of the underlying stock at December 31, 2022, using the market closing stock price, and exercise price for in-the-money awards. (2) Includes the impact of expected future forfeitures. Year Ended December 31, 2022 2021 2020 Weighted average grant date fair value of SARs granted during the year (per share) $ 34.13 $ 29.22 $ 15.73 Aggregate intrinsic value of SARs and stock options exercised during the year (in thousands) $ 2,143 $ 12,223 $ 773 Restricted Stock Units Awards The following tables present the activity for service-based RSU awards: RSUs Number of Shares Wtd. Avg. Grant Date Fair Value Non-vested shares as of December 31, 2021 791,157 $ 64.53 Granted 328,980 $ 76.35 Vested (298,865) $ 68.11 Forfeited (79,380) $ 64.85 Non-vested shares as of December 31, 2022 741,892 $ 68.02 Year Ended December 31, 2022 2021 2020 Weighted average grant date fair value of service-based RSUs issued during the year (per share) $ 76.35 $ 74.17 $ 44.28 Aggregate fair value of RSUs that vested during the year (in thousands) $ 22,793 $ 21,501 $ 13,674 The following tables present the activity for performance-based RSU awards: Performance-based RSUs Number of Shares Wtd. Avg. Grant Date Fair Value Non-vested shares as of December 31, 2021 345,944 $ 68.36 Granted 88,354 $ 92.53 Vested (11,340) $ 95.13 Forfeited (11,474) $ 41.70 Performance adjustments (1) (80,950) $ 91.58 Non-vested shares as of December 31, 2022 330,534 $ 70.45 (1) Represents the difference between the target units granted and the actual units awarded based upon the attainment of performance goals for the Company. Year Ended December 31, 2022 2021 2020 Weighted average grant date fair value of performance-based restricted share units granted during the year (per share) $ 92.53 $ 89.29 $ 41.70 Aggregate fair value of performance-based restricted share units that vested during the year (in thousands) $ 877 $ 8,268 $ 4,106

Employee Retirement Plans

Employee Retirement Plans	12 Months Ended
	Dec. 31, 2022
Retirement Benefits [Abstract]
Employee Retirement Plans	Note 17. Employee Retirement Plans Defined Benefit Plans We sponsor several defined benefit pension plans, which include plans in the U.S., Italy, Germany, Japan and France. We maintain a frozen cash balance retirement plan in the U.S. that is a contributory, defined benefit plan designed to provide the benefit in terms of a stated account balance dependent on the employer's promised interest-crediting rate. In Italy and France, we maintain a severance pay defined benefit plan that obligates the employer to pay a severance payment in case of resignation, dismissal or retirement. In other jurisdictions, we sponsor non-contributory, defined benefit plans designated to provide a guaranteed minimum retirement benefits to eligible employees. The following table presents the change in benefit obligations and funded status of our U.S. pension benefits for the years ended December 31, 2022, 2021 and 2020 (in thousands): U.S. Pension Benefits 2022 2021 2020 Accumulated benefit obligations at year end $ 9,790 $ 12,578 $ 13,085 Change in projected benefit obligation: Projected benefit obligation at beginning of year $ 12,578 $ 13,085 $ 11,232 Interest cost 254 224 290 Plan settlement (1,369) (972) (384) Actuarial (gain)/loss (1,361) 527 2,225 Benefits paid (312) (286) (278) Projected benefit obligation at end of year $ 9,790 $ 12,578 $ 13,085 Change in plan assets: Fair value of plan assets at beginning of year $ 8,020 $ 8,688 $ 7,574 Actual return on plan assets (1,189) 189 646 Employer contributions 367 401 1,130 Plan settlement (1,369) (972) (384) Benefits paid (313) (286) (278) Fair value of plan assets at end of year $ 5,516 $ 8,020 $ 8,688 Funded status at end of year: Fair value of plan assets $ 5,516 $ 8,020 $ 8,688 Projected benefit obligations 9,790 12,578 13,085 Underfunded status of the plans 4,274 4,558 4,397 Recognized liability $ 4,274 $ 4,558 $ 4,397 Amounts recognized on the consolidated balance sheets consist of: Non-current liabilities $ 4,274 $ 4,558 $ 4,397 Recognized liability $ 4,274 $ 4,558 $ 4,397 The following table presents the change in benefit obligations and funded status of our non-U.S. pension benefits for the years ended December 31, 2022, 2021 and 2020 (in thousands): Non-U.S. Pension Benefits 2022 2021 2020 Accumulated benefit obligations at year end $ 8,248 $ 10,522 $ 12,091 Change in projected benefit obligation: Projected benefit obligation at beginning of year $ 10,817 $ 13,039 $ 18,087 Service cost 259 354 691 Interest cost 83 56 121 Actuarial gain (831) (1,372) (208) Benefits paid (1,060) (294) (1,245) Reclassified to liabilities held for sale (1) — — (6,012) Foreign currency exchange rate changes and other (736) (966) 1,605 Projected benefit obligation at end of year $ 8,532 $ 10,817 $ 13,039 Change in plan assets: Fair value of plan assets at beginning of year $ 3,142 $ 2,816 $ 3,423 Actual return on plan assets (80) 61 52 Employer contributions 265 302 454 Benefits paid (37) (78) (290) Reclassified to liabilities held for sale (1) — — (1,018) Foreign currency exchange rate changes and other (58) 41 195 Fair value of plan assets at end of year $ 3,232 $ 3,142 $ 2,816 Funded status at end of year: Fair value of plan assets $ 3,232 $ 3,142 $ 2,816 Projected benefit obligations 8,532 10,817 13,039 Underfunded status of the plans (2) 5,300 7,675 10,223 Recognized liability $ 5,300 $ 7,675 $ 10,223 Amounts recognized on the consolidated balance sheets consist of: Non-current liabilities $ 5,300 $ 7,675 $ 10,223 Recognized liability $ 5,300 $ 7,675 $ 10,223 (1) Refer to “Note 5. Divestiture of Heart Valve Business.” (2) In certain non-U.S. countries, fully funding pension plans is not a common practice. Consequently, certain pension plans have been partially funded. The following tables present U.S. and non-U.S. net periodic benefit cost of the defined benefit pension plans by component for the years ended December 31, 2022, 2021 and 2020 (in thousands): U.S. Pension Benefits 2022 2021 2020 Interest cost $ 254 $ 224 $ 290 Expected return on plan assets (298) (358) (318) Settlement and curtailment loss 731 471 180 Amortization of net actuarial loss 262 264 182 Net periodic benefit cost $ 949 $ 601 $ 334 Non-U.S. Pension Benefits 2022 2021 2020 Service cost $ 259 $ 354 $ 691 Interest cost 83 56 121 Expected return on plan assets 80 (61) (52) Amortization of net actuarial loss (gain) (831) (1,372) (208) Net periodic benefit cost $ (409) $ (1,023) $ 552 To determine the discount rate for our U.S. benefit plan, we used the FTSE Above Median Pension Discount Curve. For the discount rate used for the other non-U.S. benefit plans we consider local market expectations of long-term returns, primarily utilizing the Iboxx Corporate Index Bond rating AA, duration higher than 10 years. The resulting discount rates are consistent with the duration of plan liabilities. The expected long-term rate of return on plan assets assumption for our U.S. benefit plan was derived from a study conducted by our investment managers. The study includes a review of anticipated future long-term performance of individual asset classes and consideration of the appropriate asset allocation strategy given the anticipated requirements of the plan to determine the average rate of earnings expected on the funds invested to provide for the pension plan benefits. The following table presents the major actuarial assumptions used in determining the benefit obligations and net periodic benefit cost for our significant U.S. benefit plans as of December 31, 2022, 2021 and 2020: U.S. Pension Benefits 2022 2021 2020 Weighted-average assumptions used to determine benefit obligation: Discount rate 5.10% 2.41% 1.91% Weighted-average assumptions used to determine net periodic benefit cost: Discount rate 2.41% 1.91% 2.88% Expected return on plan assets 5.00% 5.00% 5.00% The following table presents the major actuarial assumptions used in determining the benefit obligations and net periodic benefit cost for our significant non-U.S. benefit plans as of December 31, 2022, 2021 and 2020: Non-U.S. Pension Benefits 2022 2021 2020 Weighted-average assumptions used to determine benefit obligation: Discount rate 0.45% - 3.70% 0.15% - 1.00% 0.23% - 0.35% Rate of compensation increase 2.50% - 3.50% 2.50% - 3.00% 2.50% - 3.00% Weighted-average assumptions used to determine net periodic benefit cost: Discount rate 0.45% - 3.70% 0.15% - 1.00% 0.23% - 0.35% Rate of compensation increase 2.50% - 3.50% 2.50% - 3.00% 2.50% - 3.00% Retirement Benefit Plan Investment Strategy In the U.S., we have an account that holds the defined benefit frozen balance pension plan assets. The Qualified Plan Committee (the “Plan Committee”) sets investment guidelines for U.S. pension plans. The plan assets in the U.S. are invested in accordance with sound investment practices that emphasize long-term fundamentals. The investment objectives for the plan assets in the U.S. are to achieve a positive rate of return that would be expected to close the current funding deficit and so enable us to terminate the frozen pension plan at a reasonable cost. The Plan Committee also oversees the investment allocation process, selects the investment managers, and monitors asset performance. The investment portfolio contains a diversified portfolio of fixed income and equity index funds. Securities are also diversified in terms of domestic and international securities, short- and long-term securities, growth and value styles, large cap and small cap stocks. Outside the U.S., pension plan assets are typically managed by decentralized fiduciary committees. There is a significant variation in policy asset allocation from country to country. Local regulations, local funding rules, and local financial and tax considerations are part of the funding and investment allocation process in each country. The following table presents our U.S. pension plan target allocations by asset category as of December 31, 2022: Equity securities 29% Debt securities 70% Other 1% Retirement Benefit Fair Values The following is a description of the valuation methodologies used for retirement benefit plan assets measured at fair value: Equity Mutual Funds: Valued based on the year-end net asset values of the investment vehicles. The net asset values of the investment vehicles are based on the fair values of the underlying investments of the partnerships valued at the closing price reported in the active markets in which the individual security is traded. Equity mutual funds have a daily reported net asset value. Fixed Income Mutual Funds: Valued based on the year-end net asset values of the investment vehicles. The net asset values of the investment vehicles are based on the fair values of the underlying investments of the partnerships valued based on inputs other than quoted prices that are observable. Money Markets: Valued based on quoted prices in active markets for identical assets. The following tables present information by level for the retirement benefit plan assets that are measured at fair value on a recurring basis as of December 31, 2022 and 2021 (in thousands): 2022 Fair Value Measurement Using Inputs Considered as: Level 1 Level 2 Level 3 Equity mutual funds $ 1,591 $ — $ 1,591 $ — Fixed income mutual funds 3,843 — 3,843 — Money market funds and cash 68 68 — — $ 5,502 $ 68 $ 5,434 $ — 2021 Fair Value Measurement Using Inputs Considered as: Level 1 Level 2 Level 3 Equity mutual funds $ 2,341 $ — $ 2,341 $ — Fixed income mutual funds 5,587 — 5,587 — Money market funds 82 82 — — $ 8,010 $ 82 $ 7,928 $ — Refer to “Note 2. Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies” for discussion of the fair value measurement terms of Levels 1, 2, and 3. Defined Benefit Retirement Funding We make the minimum required contribution to fund the U.S. pension plan as determined by MAP - 21 and the Highway and Transportation Funding Act of 2014. We contributed $0.6 million, $0.7 million and $1.6 million to the pension plans (U.S. and non-U.S.) during the years ended December 31, 2022, 2021 and 2020, respectively. We anticipate that we will make contributions to the U.S. pension plan of approximately $0.5 million during the year ended December 31, 2023. The following table presents benefit payments expected to be paid, including amounts to be paid from our assets, and reflecting expected future service, as of December 31, 2022 (in thousands): U.S. Plans Non-U.S. Plans 2023 3,820 740 2024 688 589 2025 853 675 2026 908 634 2027 673 730 2028 - 2032 2,196 3,769 Defined Contribution Plans We sponsor defined contribution plans in the U.S. including the Cyberonics, Inc. Employee Retirement Savings Plan, which qualifies under Section 401(k) of the IRC covering U.S. employees and the Cyberonics, Inc. Non-Qualified Deferred Compensation Plan, covering certain U.S. middle and senior management. In addition, we sponsor the Belgium Defined Contribution Pension Plan for Cyberonics’ Belgium employees. We incurred expenses for our defined contribution plans of $9.0 million, $10.2 million and $11.8 million for the years ended December 31, 2022, 2021 and 2020, respectively.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Note 18. Income Taxes Earnings Before Income Taxes and Components of Income Tax Provision The following table presents the U.S. and non-U.S. components of income (loss) from continuing operations before income taxes and our income tax expense (benefit) from continuing operations for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Income (loss) from continuing operations before income taxes: Non-U.S. $ 22,570 $ 22,094 $ (262,501) U.S. (97,712) (146,566) (85,521) $ (75,142) $ (124,472) $ (348,022) Total income tax expense (benefit) from continuing operations consisted of the following: Current: Non-U.S. $ 4,782 $ 4,296 $ 2,899 U.S. 4,860 4,050 (41,010) 9,642 8,346 (38,111) Deferred: Non-U.S. 1,409 2,852 37,151 Total income tax expense (benefit) from continuing operations $ 11,051 $ 11,198 $ (960) Effective Income Tax Rate Reconciliation LivaNova PLC is resident in the UK for tax purposes. Our subsidiaries conduct operations and earn income in numerous countries and are subject to the laws of taxing jurisdictions within those countries, and the income tax rates imposed in the tax jurisdictions in which our subsidiaries conduct operations vary. As a result of the changes in the overall level of our income, the earnings mix in various jurisdictions and the changes in tax laws, our consolidated effective income tax rate may vary from one reporting period to another. The following table presents a reconciliation of the statutory income tax rate to our effective income tax rate expressed as a percentage of income from continuing operations before income taxes for the years ended December 31, 2022, 2021 and 2020: 2022 2021 2020 Statutory tax rate at UK Rate 19.0 % 19.0 % 19.0 % Deferred tax valuation allowance (18.8) (47.7) (34.9) Foreign tax rate differential 10.6 7.1 6.6 U.S. state and local tax expense, net of federal benefit (1.4) (0.3) 1.5 Effect of changes in tax rate 6.2 18.9 2.2 Write-off/impairment of investments (27.6) (1.8) 1.8 Reserve for uncertain tax positions — — 0.8 Research and development tax credits 1.2 0.3 0.9 Base erosion anti-abuse tax (2.9) (3.1) (0.7) Foreign tax withholding and credits — (0.2) (0.2) CARES Act rate differential — — 2.8 Disallowable professional fees (0.4) (1.5) — Other, net (0.6) 0.3 0.5 Effective tax rate (14.7) % (9.0) % 0.3 % Inflation Reduction Act of 2022 On August 16, 2022, the Inflation Reduction Act of 2022 (the “IRA”) was enacted in the U.S. The IRA is effective for tax years beginning after December 31, 2022 and introduces a 15% alternative minimum tax on corporations with an average annual adjusted financial statement income greater than $1 billion and a 1% excise tax on the net fair market value of stock repurchases. While we do not anticipate a significant tax impact from the IRA, we will continue to evaluate as additional guidance becomes availabl e. Deferred Income Tax Assets and Liabilities The following table presents the significant components of our deferred tax assets and liabilities as of December 31, 2022 and 2021 (in thousands): 2022 2021 Deferred tax assets: Net operating loss carryforwards $ 142,456 $ 152,491 Tax credit carryforwards 41,918 40,931 Interest expense carryforward 65,497 65,141 Accruals and reserves 35,132 36,796 Deferred compensation 16,081 13,262 Inventories 9,073 8,844 Deferred R&D 29,796 — Other 6,898 19,119 Gross deferred tax assets 346,851 336,584 Valuation allowance (264,754) (244,978) Net deferred tax assets 82,097 91,606 Deferred tax liabilities: Property, equipment & intangible assets (76,419) (70,573) Gain on sale of intellectual property (12,810) (26,564) Gross deferred tax liabilities: (89,229) (97,137) Net deferred tax liabilities $ (7,132) $ (5,531) Reported on the consolidated balance sheet as (after valuation allowance and jurisdictional netting): Net deferred tax assets $ 1,384 $ 2,197 Net deferred tax liabilities (8,516) (7,728) Net deferred tax liabilities $ (7,132) $ (5,531) The following table presents NOL and tax credit carryforwards as of December 31, 2022, which can be used to reduce our income tax payable in future years (in thousands): Region Gross Amount Tax Benefit Amount Amount with Expiration Carryforward Period Europe NOL $ 429,156 $ 104,075 $ 104,075 $ — Unlimited U.S. Federal NOL 112,259 23,574 8,474 15,100 2023 - 2038 U.S. State NOL 180,411 11,076 2,349 8,727 2023 - 2042 S. America & other regions NOL 11,183 3,664 3,410 254 2029 - 2038 Far East NOL 426 79 27 52 2025 - 2032 U.S. foreign tax credits — 15,850 — 15,850 2025 - 2030 U.S. R&D tax credits — 17,690 — 17,690 2023 - 2042 U.S. State research & development tax credits — 7,108 1,280 5,828 2030 - 2042 Other non-U.S. tax credits — 1,271 275 996 2023 - 2034 $ 733,435 $ 184,387 $ 119,890 $ 64,497 We review the realizability of our deferred tax assets by jurisdiction regularly. As of December 31, 2022 and 2021, we had valuation allowances of $264.8 million and $245.0 million, respectively. These valuation allowances were primarily related to continuing operations and are a result of significant negative evidence in the form of cumulative losses in certain jurisdictions, including the extended impact of COVID-19 globally. No provision has been made for income taxes on undistributed earnings of foreign subsidiaries as of December 31, 2022 because it is our intention to indefinitely reinvest undistributed earnings of our foreign subsidiaries. In the event of the distribution of those earnings in the form of dividends, a sale of the subsidiaries, or certain other transactions, we may be liable for income taxes and withholding taxes. As of December 31, 2022, it was not practicable to determine the exact amount of the deferred tax liability related to those investments. Uncertain Income Tax Positions The following table presents a reconciliation of our total gross unrecognized tax benefit for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Balance at beginning of year $ 1,741 $ 3,433 $ 15,995 Decreases: Tax positions related to prior years for settlement with tax authorities — (1,434) (13,989) Impact of foreign currency exchange rates (101) (258) 1,427 Balance at end of year $ 1,640 $ 1,741 $ 3,433 Accrued interest and penalties totaled $0.3 million, $0.2 million and $0.4 million as of December 31, 2022, 2021 and 2020, respectively, and were included in other long-term liabilities on our consolidated balance sheets. We operate in multiple jurisdictions with complex legal and tax regulatory environments and our tax returns are periodically audited or subjected to review by tax authorities. We monitor tax law changes and the potential impact to our results of operations. Tax authorities may disagree with certain positions we have taken and assess additional taxes. We regularly assess the likely outcomes of our tax positions in order to determine the appropriateness of our reserves for uncertain tax positions. However, there can be no assurance that we will accurately predict the outcome of these audits and the actual outcome of an audit could have a material impact on our consolidated results of income, financial position or cash flows. If all of our unrecognized tax benefits as of December 31, 2022 were recognized, $1.6 million would impact our effective tax rate. We believe it is reasonably possible that, within the next twelve months, due to the settlement of uncertain tax positions with various tax authorities and the expiration of statutes of limitations, unrecognized tax benefits should decrease by up to approximately $1.0 million. We record accrued interest and penalties related to unrecognized tax benefits in interest expense and foreign exchange and other income/(expense), respectively, on our consolidated statements of income (loss). The major jurisdictions where we are subject to income tax examinations are as follows: Jurisdiction Earliest Year Open U.S. - federal and state 2015 Italy 2016 Germany 2019 England and Wales 2018 Canada 2018

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Earnings Per Share	Note 19. Earnings Per Share The following table presents the basic and diluted weighted-average shares outstanding used in the computation of basic and diluted net income per share for the years ended December 31, 2022, 2021 and 2020 (in thousands of shares): 2022 2021 2020 Basic and diluted weighted average shares outstanding (1) 53,472 50,633 48,592 (1) Excluded from the computation of diluted earnings per share for the years ended December 31, 2022, 2021 and 2020 were stock options, SARs and RSUs t otaling 3.9 million, 3.9 million and 4.1 million because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Informat

Geographic and Segment Information	12 Months Ended
	Dec. 31, 2022
Segment Reporting [Abstract]
Geographic and Segment Information	Note 20. Geographic and Segment Information Segment Information We identify operating segments based on the way we manage, evaluate and internally report our business activities for purposes of allocating resources, developing and executing our strategy, and assessing performance. We have three reportable segments: Cardiopulmonary, Neuromodulation and Advanced Circulatory Support. Our Cardiopulmonary segment is engaged in the development, production and sale of cardiopulmonary products, including heart-lung machines, oxygenators, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Our Neuromodulation segment is engaged in the design, development and marketing of devices that deliver neuromodulation therapy for treating DRE and DTD. Neuromodulation products include the LivaNova VNS Therapy System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. It also includes the development and management of clinical testing of our aura6000 System for treating obstructive sleep apnea. Our Neuromodulation segment also includes the VITARIA System which was intended to treat heart failure by stimulating the right vagus nerve. Our Advanced Circulatory Support (“ACS”) segment is engaged in the development, production and sale of leading-edge temporary life support products. Our ACS products, which comprise the LifeSPARC platform and ProtekDuo cannula, simplify temporary extracorporeal cardiopulmonary life support solutions for critically ill patients. The LifeSPARC platform includes a common compact console and pump that provides temporary support for emergent rescue patients in a variety of settings. Our ACS segment also includes the Hemolung RAS, which was acquired in May 2022 as part of the acquisition of ALung. “Other” includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. For the years ended December 31, 2021 and 2020, Other also includes the results of our Heart Valve business, which was divested on June 1, 2021. Net revenue of our reportable segments includes revenues from the sale of products that each reportable segment develops and manufactures or distributes. We define segment income as operating income before merger and integration, restructuring and amortization of intangibles. We operate under three geographic regions: U.S., Europe, and Rest of World. The following table presents net revenue by operating segment and geographic region for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary United States $ 159,489 $ 154,073 $ 132,543 Europe (1) 127,064 134,562 122,062 Rest of World 213,761 194,344 192,127 500,314 482,979 446,732 Neuromodulation United States 374,542 358,476 282,509 Europe (1) 50,291 51,435 39,019 Rest of World 52,160 46,261 32,916 476,993 456,172 354,444 Advanced Circulatory Support United States 37,527 53,821 41,094 Europe (1) 1,447 1,120 1,027 Rest of World 327 518 200 39,301 55,459 42,321 Other (2) United States — 4,929 12,488 Europe (1) — 14,407 31,259 Rest of World 5,197 21,419 46,997 5,197 40,755 90,744 Totals United States 571,558 571,299 468,634 Europe (1) 178,802 201,524 193,367 Rest of World 271,445 262,542 272,240 Total net revenue (3) (4) $ 1,021,805 $ 1,035,365 $ 934,241 (1) Includes countries in Europe where we have a direct sales presence. Countries where sales are made through distributors are included in “Rest of World.” (2) For the years ended December 31, 2021 and 2020, other primarily includes the net revenue of the Company’s Heart Valve business, which was divested on June 1, 2021. (3) Net revenue to external customers includes $32.3 million, $35.8 million and $29.7 million in the United Kingdom, our country of domicile, for the years ended December 31, 2022, 2021 and 2020, respectively. (4) No single customer represented over 10% of our consolidated net revenue. No country’s net revenue exceeded 10% of our consolidated sales, except for the U.S. The following table presents a reconciliation of segment (loss) income from continuing operations to consolidated loss from continuing operations before tax for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary (1) $ 11,247 $ (6,429) $ 35,735 Neuromodulation 172,775 169,499 109,273 Advanced Circulatory Support (2) (142,590) 2,195 (575) Other (3) (4) (85,249) (129,082) (365,116) Total reportable segment (loss) income from continuing operations (43,817) 36,183 (220,683) Other expenses (5) 32,935 36,967 53,216 Operating loss from continuing operations (76,752) (784) (273,899) Interest expense (48,250) (50,151) (40,837) Loss on debt extinguishment — (60,238) (1,407) Foreign exchange and other income/(expense) 49,860 (13,299) (31,879) Loss from continuing operations before tax $ (75,142) $ (124,472) $ (348,022) (1) Results for the years ended December 31, 2022, 2021 and 2020 include a Litigation provision, net of $21.7 million, $38.1 million and $3.9 million, respectively. Refer to “Note 14. Commitments and Contingencies” for additional information. (2) Results for the year ended December 31, 2022 include a goodwill impairment of $129.4 million. Refer to “Note 8. Goodwill and Intangible Assets” for additional information. (3) Other includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. For the years ended December 31, 2021 and 2020, Other also includes the results of our Heart Valve business, which was divested on June 1, 2021. (4) Results for the year ended December 31, 2020 include $180.2 million and $21.3 million in impairments of the Heart Valves disposal group and allocated goodwill, respectively. Additionally, the results for the year ended December 31, 2020 include a $42.2 million decommissioning provision at our Saluggia site. Refer to “Note 5. Divestiture of Heart Valve Business” and “Note 14. Commitments and Contingencies”, respectively, for additional information. (5) Other expenses consists of merger and integration expense, restructuring expense and amortization of intangible assets. The following table presents assets by reportable segment as of December 31, 2022 and 2021 (in thousands): 2022 2021 Cardiopulmonary $ 874,143 $ 921,481 Neuromodulation 646,633 646,394 Advanced Circulatory Support 121,454 231,846 Other 652,543 401,230 Total assets $ 2,294,773 $ 2,200,951 The following table presents capital expenditures by segment for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary $ 13,828 $ 14,824 $ 20,975 Neuromodulation 369 179 7,318 Advanced Circulatory Support 1,773 1,326 733 Other (1) 10,622 5,984 6,890 Total capital expenditures $ 26,592 $ 22,313 $ 35,916 (1) Other includes corporate capital expenditures. For the years ended December 31, 2021 and 2020, Other also includes capital expenditures of our Heart Valve business, which was divested on June 1, 2021. Geographic Information The following table presents property, plant and equipment, net by geographic region as of December 31, 2022 and 2021 (in thousands): 2022 2021 United States $ 63,458 $ 60,852 Europe 79,654 85,313 Rest of World 4,075 3,901 Total property, plant and equipment, net $ 147,187 $ 150,066

Supplemental Financial Informat

Supplemental Financial Information	12 Months Ended
	Dec. 31, 2022
Receivables [Abstract]
Supplemental Financial Information	Note 21. Supplemental Financial Information The following table presents the components of inventories as of December 31, 2022 and 2021 (in thousands): 2022 2021 Raw materials $ 70,027 $ 43,958 Work-in-process 15,508 14,161 Finished goods 43,844 47,721 Total inventories $ 129,379 $ 105,840 Inventories included adjustments totaling $8.2 million and $8.9 million as of December 31, 2022 and 2021, respectively, to record balances at lower of cost or net realizable value. The following table presents the components of property, plant and equipment, net as of December 31, 2022 and 2021 (in thousands): 2022 2021 Lives in Years Land $ 14,637 $ 15,099 Building and building improvements 80,611 79,475 5 to 36 Equipment, software, furniture and fixtures 206,892 195,919 2 to 10 Other 8,861 9,246 5 to 7 Capital investment in process 11,307 12,112 Total gross property, plant and equipment 322,308 311,851 Accumulated depreciation (175,121) (161,785) Total Property, plant and equipment, net $ 147,187 $ 150,066 The following table presents the components of accrued liabilities and other as of December 31, 2022 and 2021 (in thousands): 2022 2021 Contract liabilities $ 10,226 $ 8,419 Operating lease liabilities (1) 9,379 11,261 Legal and other administrative costs 8,653 11,832 Research and development costs 7,020 5,329 Italian medical device payback law 6,414 5,533 Royalty accrual 3,950 3,611 Restructuring liabilities (2) 2,045 836 Provisions for agents, returns and other 1,678 2,535 Contingent consideration (3) — 11,552 Amount payable to Gyrus Capital S.A. — 11,418 Other accrued expenses 26,230 16,611 Total accrued liabilities and other $ 75,595 $ 88,937 (1) Refer to “Note 13. Leases.” (2) Refer to “Note 6. Restructuring.” (3) Refer to “Note 10. Fair Value Measurements.” The following table presents the items included within foreign exchange and other income/(expense) on the consolidated statements of income (loss) for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Notes fair value adjustment (1) $ 96,025 $ (59,944) $ (46,805) Capped call fair value adjustment (1) (52,236) 34,327 29,206 Interest income 4,697 435 131 Foreign exchange rate fluctuations 378 (1,243) (4,851) Dividend income (2) 305 3,415 — Investment revaluation (2) — 4,642 — Other derivative liabilities fair value adjustment (1) — 4,290 (4,290) Notes issuance costs — — (2,482) Other 691 779 (2,788) Total foreign exchange and other income/(expense) $ 49,860 $ (13,299) $ (31,879) (1) Refer to “Note 10. Fair Value Measurements.” (2) Refer to “Note 9. Investments.” The following table presents a reconciliation of cash, cash equivalents and restricted cash reported on the consolidated balance sheets that sum to the total of the amounts shown on the consolidated statement of cash flows as of December 31, 2022 and 2021 (in thousands): 2022 2021 Cash and cash equivalents $ 214,172 $ 207,992 Restricted cash (1) 301,446 — Cash, cash equivalents and restricted cash $ 515,618 $ 207,992 (1) Restricted cash represents funds held as collateral for the SNIA Litigation Guarantee. Refer to “Note 14. Commitments and Contingencies.”

Subsequent Event

Subsequent Event	12 Months Ended
	Dec. 31, 2022
Subsequent Events [Abstract]
Subsequent Event	Note 22. Subsequent Event During the fourth quarter of 2022, we randomized the 500th patient in the ANTHEM-HFrEF clinical trial which triggered the second interim analysis. The independent Data and Safety Monitoring Committee (“DSMC”) evaluated safety, a trend toward the primary endpoint and success in the three functional endpoints. This analysis determined that the U.S. FDA early filing conditions were not met, and the DSMC recommended that enrollment continue in accordance with the current study protocol. However, we conducted further evaluation of the study data and concluded that such data did not demonstrate a sufficiently strong positive impact on functional or mortality endpoints and that it was unlikely that the continuation of the study would demonstrate such an impact. As a result, on February 22, 2023, we announced that we are stopping enrollment in the ANTHEM-HFrEF clinical trial, beginning the process to close the clinical study and winding down our heart failure program.

Basis of Presentation, Use of_2

Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying consolidated financial statements of LivaNova have been prepared in accordance with accounting principles generally accepted in the U.S. (“U.S. GAAP”).
Consolidation	Consolidation The accompanying consolidated financial statements for LivaNova include LivaNova’s wholly owned subsidiaries and the LivaNova PLC Employee Benefit Trust (“the Trust”). All intercompany accounts and transactions have been eliminated.
Use of Estimates	Use of Estimates The preparation of our consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in such financial statements and accompanying notes. These estimates are based on management’s best knowledge of current events and actions we may undertake in the future. Estimates are used in accounting for, among other items, valuation and amortization of intangible assets, goodwill, measurement of deferred tax assets and liabilities, uncertain income tax positions, contingent consideration arrangements, legal and other contingencies, stock-based compensation, obsolete and slow-moving inventories, models, such as an impairment analysis, and in general, allocations to provisions and the fair value of assets and liabilities recorded in a business combination. Actual results could differ materially from those estimates.
Reclassification	ReclassificationsWe have reclassified certain prior period amounts on the consolidated statements of income (loss) and the consolidated statements of cash flows for comparative purposes. These reclassifications did not have a material effect on our financial condition, results of operations or cash flows.
Cash and Cash Equivalents/Restricted Cash	Cash and Cash Equivalents We consider all highly liquid investments with an original maturity of three months or less, consisting of demand deposit accounts and money market mutual funds, to be cash equivalents. Cash equivalents are carried on the consolidated balance sheet at cost, which approximates their fair value. Restricted Cash The Company classifies cash that is not available for use in its operations as restricted cash within current assets on the consolidated balance sheet. As of December 31, 2022, our restricted cash balance totaled $301.4 million and was comprised of cash deposits with Barclays held as collateral for the SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. For additional information regarding the SNIA litigation, please refer to “Note 14. Commitments and Contingencies.”
Accounts Receivable	Accounts ReceivableOur accounts receivable consisted of trade receivables from direct customers and distributors. We maintain an allowance for doubtful accounts for potential credit losses based on our estimates of the ability of customers to make required payments, historical credit experience, existing economic conditions and expected future trends. We write off uncollectible accounts against the allowance when all reasonable collection efforts have been exhausted.
Inventories	InventoriesWe state our inventories at the lower of cost, using the first-in first-out (“FIFO”) method, or net realizable value. Our calculation of cost includes the acquisition cost of raw materials and components, direct labor and overhead, including depreciation of manufacturing related assets. We reduce the carrying value of inventories for those items that are potentially excess, obsolete or slow moving based on changes in customer demand, technology developments or other economic factors.
Property, Plant and Equipment (PP&E)	Property, Plant and Equipment (“PP&E”)PP&E is carried at cost, less accumulated depreciation. Maintenance, repairs and minor replacements are charged to expense as incurred, while significant renewals and improvements are capitalized. We compute depreciation using the straight-line method over estimated useful lives. Leasehold improvements are depreciated over the shorter of the following terms: the useful life of the asset or a term that includes required lease periods and renewals that are deemed to be reasonably assured at the date the leasehold improvements are purchased. Capital improvements to the building are added as building components and depreciated over the useful life of the improvement or the building, whichever is less.
Goodwill	GoodwillWe allocate the amounts we pay for an acquisition to the assets we acquire and liabilities we assume based on their fair values at the date of acquisition, including property, plant and equipment, inventories, accounts receivable, long-term debt, and identifiable intangible assets which either arise from a contractual or legal right or are separable from goodwill. We base the fair value of identifiable intangible assets acquired in a business combination, including IPR&D, on valuations that use information and assumptions provided by management, which consider management’s best estimates of inputs and assumptions that a market participant would use. We allocate any excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired to goodwill. Transaction costs associated with these acquisitions are expensed as incurred and are reported in selling, general and administrative on the consolidated statements of income (loss). We recognize adjustments to the provisional amounts identified during the measurement period with a corresponding adjustment to goodwill in the reporting period in which the adjustment amounts are determined. The effect on earnings of changes in depreciation, amortization or other income effects, if any, as a result of the change to the provisional amounts are recorded in the same period’s consolidated financial statements, calculated as if the accounting had been completed at the acquisition date.
Intangible Assets, Other than Goodwill	Intangible Assets, Other than Goodwill Intangible assets shown on the consolidated balance sheets consist of finite-lived and indefinite-lived assets expected to generate future economic benefits and are recorded at their respective fair values as of their acquisition date. Finite-lived
Impairments of Long-Lived Assets, Investments and Goodwill	Impairments of Long-lived Assets and Goodwill Long-lived Assets Impairment Assets Held and Used We evaluate the carrying value of our long-lived assets and investments for impairment when events or changes in circumstances indicate that the carrying value of such assets may not be recoverable. Such changes in circumstance may include, among other items, (i) an expectation of a sale or disposal of a long-lived asset or asset group, (ii) adverse changes in market or competitive conditions, (iii) an adverse change in legal factors or business climate in the markets in which we operate and (iv) operating or cash flow losses. For PP&E and intangible assets used in our operations, recoverability generally is determined by comparing the carrying value of an asset or group of assets to their expected undiscounted future cash flows. If the carrying value of an asset (asset group) is not recoverable, the amount of impairment loss is measured as the difference between the carrying value of the asset (asset group) and its estimated fair value. The asset grouping as well as the determination of expected undiscounted cash flow amounts requires significant judgments, estimates, and assumptions, including cash flows generated upon disposition. We measure fair value as the price that would be received if we were to sell the assets in an orderly transaction. Assets to be disposed of are carried at the lower of their financial statement carrying amount or fair value less costs to sell. We conduct impairment testing of our indefinite-lived intangible assets on October 1st each year. We test indefinite-lived intangible assets for impairment between annual tests if an event occurs or circumstances change that would indicate the carrying amount may be impaired. An impairment loss is recognized when the asset's carrying value exceeds its fair value. Assets Held for Sale We classify long-lived assets as held for sale in the period in which we commit to a plan to sell the asset, the asset is available for immediate sale, the asset is being actively marketed for sale at a price that is reasonable in relation to its current fair value and the sale of the asset is probable within the next twelve months and when actions required to complete the plan indicate that it is unlikely that significant changes to the plan will be made or that the plan will be withdrawn. A long-lived asset classified as held for sale is measured at the lower of its carrying amount or fair value less cost to sell and depreciation is discontinued. We recognize an impairment for any excess of carrying value over the fair value less cost to sell. When an impairment of a disposal group is deemed necessary and the amount of the impairment exceeds the carrying value of the long-lived assets, we record the impairment to the disposal group rather than long-lived assets. We also allocate goodwill of the associated reporting unit to the disposal group based upon the relative fair value of the businesses within the reporting unit. The goodwill allocated to the disposal group is then tested for impairment. Goodwill Impairment We conduct impairment testing of our goodwill on October 1st each year. Testing is performed at the reporting unit level, which is defined as an operating segment or a component of an operating segment that constitutes a business for which financial information is available and is regularly viewed by management. Our operating segments are deemed to be our reporting units for purposes of goodwill impairment testing. We test goodwill for impairment between annual tests if an event occurs or circumstances change that would more-likely-than-not reduce the fair value of a reporting unit below its carrying amount. If we determine that goodwill is more-likely-than-not impaired, we compare the fair value of the reporting unit to its carrying amount, including goodwill. Fair value refers to the price that would be received if we were to sell the unit as a whole in an orderly transaction. Fair value is estimated using a discounted cash flow model and requires various assumptions, including revenue growth rates. If the carrying amount of our reporting unit is greater than zero and its fair value exceeds its carrying amount, goodwill of the reporting unit is considered not impaired. An impairment loss is recognized when the carrying amount of the reporting unit’s net assets exceeds the estimated fair value of the reporting unit, up to and including the carrying amount of the goodwill. If the aggregate fair value of our reporting units exceeds our market capitalization, we evaluate the reasonableness of the implied control premium which includes a comparison to implied control premiums from recent market transactions within our industry or other relevant benchmark data. Goodwill impairment evaluations are highly subjective. In most instances, they involve expectations of future cash flows that reflect our judgments and assumptions regarding future industry conditions and operations. The estimates, judgments and assumptions used in the application of our goodwill impairment policies reflect both historical experience and an assessment of current operational, industry, market, economic and political environments. The use of different estimates, judgments, assumptions and expectations regarding future industry and market conditions and operations would likely result in materially different asset carrying values and operating results. Quantitative factors used to determine the fair value of the reporting units reflect our best estimates, and we believe they are reasonable. Future declines in the reporting units’ operating performance or our anticipated business outlook may reduce the estimated fair value of our reporting units and result in an impairment. Factors that could have a negative impact on the fair value of the reporting units include, but are not limited to: • decreases in revenue as a result of the inability of our sales force to effectively market and promote our products; • increased competition, patent expirations or new technologies or treatments; • declines in anticipated growth rates; • the outcome of litigation, legal proceedings, investigations or other claims resulting in significant cash outflows; and • increases in the market-participant risk-adjusted Weighted Average Cost of Capital (“WACC”).
Derivatives and Risk Management	Derivatives and Risk Management U.S. GAAP requires companies to recognize all derivatives as assets and liabilities on the balance sheet and to measure the instruments at fair value through earnings unless the derivative qualifies for hedge accounting. 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 other comprehensive income (“OCI”) until the hedged item is recognized in earnings. The changes in the fair value of the derivative are intended to offset the change in fair value of the hedged asset, liability or probable commitment. We evaluate hedge effectiveness at inception. Cash flows from derivative contracts are reported as operating activities on the consolidated statements of cash flows. We use currency exchange rate derivative contracts to manage the impact of currency exchange on earnings and cash flows. Forward currency exchange rate contracts are designed to hedge anticipated foreign currency transactions and changes in the value of specific assets and liabilities. At inception of the forward contract, the derivative is designated as either a freestanding derivative or a cash flow hedge. We do not enter into derivative contracts for speculative purposes. All derivative instruments are recorded at fair value on the consolidated balance sheets, as assets or liabilities (current or non-current) depending upon the gain or loss position of the contract and contract maturity date. Forward contracts designated as cash flow hedges are designed to hedge the variability of cash flows associated with forecasted transactions denominated in a foreign currency that will take place in the future. For derivative instruments that are designated and qualify as a cash flow hedge, the gain or loss on the derivative instrument is reported as a component of accumulated other comprehensive income (“AOCI”) and reclassified into earnings to offset exchange differences originated by the hedged item or the current earnings effect of the hedged item. Upon the settlement of our foreign currency cash flow hedges in the fourth quarter of 2022 and following an in-depth analysis of the utility of our cash flow hedging program, we discontinued our foreign currency cash flow hedging program. We continue to use freestanding derivative forward contracts to offset exposure to the variability of the value associated with assets and liabilities denominated in a foreign currency. These derivatives are not designated as hedges, and therefore changes in the value of these forward contracts are recognized in earnings, thereby offsetting the current earnings effect of the related change in value of foreign currency denominated assets and liabilities. We currently use interest rate derivative instruments designated as cash flow hedges to manage the exposure to interest rate movements and to reduce the risk of increased borrowing costs by converting floating-rate debt into fixed-rate debt. Under these agreements, we agree to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to agreed-upon notional principal amounts. The interest rate swaps are structured to mirror the payment terms of the underlying loan. The fair value of the interest rate swaps is reported on the consolidated balance sheets as assets or liabilities (current or non-current) depending upon the gain or loss position of the contract and the maturity of the future cash
Fair Value Measurements	Fair Value Measurements We follow the authoritative guidance on fair value measurements and disclosures with respect to assets and liabilities that are measured at fair value on both a recurring and nonrecurring basis. Under this guidance, fair value is defined as the exit price, or the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants as of the measurement date. The authoritative guidance also establishes a hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability, based on market data obtained from sources independent of us. Unobservable inputs are inputs that reflect our assumptions about the factors market participants would use in valuing the asset or liability developed based upon the best information available in the circumstances. The categorization of financial assets and financial liabilities within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement. The hierarchy is broken down into three levels defined as follows: • Level 1 - Inputs are quoted prices in active markets for identical assets or liabilities; • Level 2 - Inputs include quoted prices for similar assets or liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs (other than quoted prices) that are observable for the asset or liability, either directly or indirectly; and • Level 3 - Inputs are unobservable for the asset or liability. Our financial assets and liabilities classified as Level 2 include derivative instruments, primarily forward and option currency contracts and interest rate swap contracts, which are valued using standard calculations and models that use readily observable market data as their basis. Our financial assets and liabilities classified as Level 3 include contingent consideration liability arrangements, derivative and embedded derivative instruments and convertible notes receivable.
Investments in Equity Securities	Investments in Equity Securities Our investments in equity securities, and related loans, are investments in affiliates that are in varied stages of development and not publicly traded. Our equity investments are reported in investments, and related loans in other assets, on the consolidated balance sheets. We elect to measure 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. Our investments in affiliates in which we have significant influence but not control are accounted for using the equity method. Our share of net income or loss is reflected as one line item on our consolidated statements of income (loss) under losses from losses from equity-method investments and will increase or decrease, as applicable, the carrying value of our equity method investments reported under investments on the consolidated balance sheets. We regularly review our investments for changes in circumstance or the occurrence of events that suggest our investment may not be recoverable, and if an impairment
Warranty Obligation	Warranty ObligationWe offer a warranty on various products. We estimate the costs that may be incurred under warranties and record a liability in the amount of such costs at the time the product is sold. The amount of the reserve recorded is equal to the net costs to repair or otherwise satisfy the claim. We include the warranty obligation in accrued liabilities and other on the consolidated balance sheets. Warranty expense is recorded to cost of goods sold on our consolidated statements of income (loss).
Retirement Benefit Plan Assumptions	Retirement Benefit Plan Assumptions We sponsor various retirement benefit plans, including defined benefit pension plans (pension benefits), defined contribution savings plans and termination indemnity plans, covering substantially all U.S. employees and employees outside the U.S. Pension benefit costs include assumptions for the discount rate, retirement age, compensation rate increases and the expected return on plan assets.
Product Liability Accruals	Product Liability AccrualsAccruals for product liability claims are recorded when it is probable that a liability has been incurred and the amount of the liability can be reasonably estimated based on existing information. Accruals for product liability claims are adjusted periodically as additional information becomes available.
Revenue Recognition	Revenue Recognition Refer to “Note 3. 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 consolidated 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 have been capitalized as contract costs since adoption of ASC 606. 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 20. Geographic and Segment Information.” Cardiopulmonary Products and Services Cardiopulmonary products include HLMs, oxygenators, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. 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. 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 Cardiopulmonary revenue and have been presented with the related equipment and accessories revenue. Neuromodulation Products Neuromodulation products are comprised of neuromodulation therapy systems for the treatment of drug-resistant epilepsy (“DRE”) and difficult-to-treat depression (“DTD”). Our Neuromodulation product line includes the Vagus Nerve Stimulation Therapy (“VNS Therapy”) System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. We recognize revenue for Neuromodulation product sales when control passes to the customer. Advanced Circulatory Support Products Advanced Circulatory Support (“ACS”) products are comprised of the LifeSPARC platform, ProtekDuo cannula kits and the Hemolung Respiratory Assist System (“Hemolung RAS”). The LifeSPARC platform includes a common compact console and pump that provides temporary support for emergent rescue patients in a variety of settings. The platform is accompanied by four specialized ProtekDuo cannula kits designed to support diverse cannulation strategies. The Hemolung RAS, which was acquired in May 2022 as part of the acquisition of ALung, is the only FDA-cleared platform designed specifically for low-flow extracorporeal carbon dioxide removal for acute respiratory failure. Advanced Circulatory Support revenue is recognized when control passes to the customer, usually at the point of shipment. Contract Balances
Research and Development	Research and Development All R&D costs are expensed as incurred. R&D includes costs of basic research activities as well as engineering and technical effort required to develop a new product or make significant improvements to an existing product or manufacturing process. R&D costs also include regulatory and clinical study expenses, including post-market clinical studies.
Leases	Leases We determine if an arrangement is or contains a lease at its inception. For operating leases with a term greater than 12 months, we recognize operating lease assets and operating lease liabilities based on the present value of the future minimum lease payments over the lease term at the latter of our lease standard adoption date of January 1, 2019, or the lease commencement date. We do not record an operating lease asset and corresponding liability for leases with terms of 12 months or less. We recognize the lease payments for such short-term leases within profit and loss on a straight-line basis over the lease term. Variable lease payments, such as common area rent, maintenance charges, and rent escalations not known upon lease commencement, are not included in the determination of the minimum lease payments and are expensed in the period in which the obligation for those payments is incurred. The operating lease asset also includes any lease payments made in advance and excludes lease incentives. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. As most of our leases do not provide a readily determinable implicit rate, we use our incremental borrowing rate (“IBR”) based on the information available at the lease commencement date in determining the present value of future payments. Our IBR represents an estimate of the interest rate we would incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis over the lease term within a particular currency environment. We used the IBR available nearest to our adoption date for leases that commenced prior to that date. Additionally, we monitor for events or changes in circumstances that may require a reassessment of our leases and determine if a remeasurement is required. For additional information, refer to “Note 13. Leases.”
Stock-Based Compensation	Stock-Based Compensation Stock-Based Awards We may grant stock-based awards to directors, officers and key employees. We measure the cost of employee services received in exchange for an award of equity instruments based on the grant date fair market value of the award. We recognize equity-based compensation expense ratably over the period that an employee is required to provide service in exchange for the entire award (all vesting periods). We issue new shares upon stock option exercises, otherwise issuance of stock for vesting of restricted stock units or exercises of stock appreciation rights are issued from treasury shares. We have the right to elect to pay the cash value of vested restricted stock units in lieu of the issuance of new shares. Stock Appreciation Rights (“SARs”) A SAR confers upon an employee the contractual right to receive an amount of cash, stock, or a combination of both that equals the appreciation in the company’s stock from an award’s grant date to the exercise date. SARs may be exercised at the employee’s discretion during the exercise period and do not give the employee an ownership right in the underlying stock. SARs do not involve payment of an exercise price. We use the Black-Scholes option pricing methodology to calculate the grant date fair market value of SARs and compensation is expensed ratably over the service period. We determine the expected volatility of the awards based on historical volatility. Calculation of compensation for stock awards requires estimation of volatility, employee turnover and forfeiture rates. Restricted Stock Units (“RSUs”) We may grant RSUs at no purchase cost to the grantee. The grantees of unvested RSUs have no voting rights or rights to dividends. Sale or transfer of the stock and stock units is restricted until they are vested. The fair market value of service-based RSUs is determined using the market closing price on the grant date, and compensation is expensed ratably over the service period. Calculation of compensation for stock awards requires estimation of employee turnover and forfeiture rates. Market Performance-Based RSU’s We may grant market performance-based RSUs at no purchase cost to the grantee. The grantees of the units have no voting rights or rights to dividends. Sale or transfer of the units is restricted until they are vested. The number of shares that are ultimately transferred to the grantee is dependent upon the Company’s percentile rank of total shareholder return relative to a peer group. The fair market value of market performance-based RSUs is determined utilizing a Monte Carlo simulation on the grant date and compensation is expensed ratably over the service period. Calculation of compensation for market performance-based stock awards requires estimation of employee turnover, historical volatility and forfeiture rates. Operating Performance-Based Awards RSU’s We may grant operating performance-based RSUs at no purchase cost to the grantee. The grantees of the units have no voting rights or rights to dividends. Sale or transfer of the units is restricted until they are vested. The number of shares that are ultimately transferred to the grantee is dependent upon the Company’s achievement of certain thresholds for cumulative adjusted free cash flow and adjusted return on invested capital. The fair market value of operating performance-based RSUs is determined using the market closing price on the grant date. Compensation is expensed ratably over the service period and adjusted based upon the percent achievement of cumulative adjusted free cash flow. Calculation of compensation expense for operating performance-based stock awards requires estimation of employee turnover, adjusted free cash flow, adjusted return on invested capital and forfeiture rates.
Income Taxes	Income Taxes We are a UK corporation, and we operate through our various subsidiaries in a number of countries throughout the world. Our provision for income taxes is based on the tax laws and rates applicable in the jurisdictions in which we operate and earn income. We use significant judgment and estimates in accounting for our income taxes. We recognize deferred tax assets and liabilities for the anticipated future tax effects of temporary differences between the financial statements basis and the tax basis of our assets and liabilities, which are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. We periodically assess the recoverability of our deferred tax assets by considering whether it is more-likely-than-not that some or all of the actual benefit of those assets will be realized. To the extent that realization does not meet the “more-likely-than-not” criterion, we establish a valuation allowance. We periodically review the adequacy and necessity of the valuation allowance by considering significant positive and negative evidence relative to our ability to recover deferred tax assets and to determine the timing and amount of valuation allowance that should be released. This evidence includes: profitability in the most recent quarters; internal forecasts for the current and next two future years; size of deferred tax asset relative to estimated profitability; the potential effects on future profitability from increasing competition, healthcare reforms and overall economic conditions; limitations and potential limitations on the use of our net operating losses due to ownership changes, pursuant to Internal Revenue Code (“IRC”) Section 382; and the implementation of prudent and feasible tax planning strategies, if any. We file federal and local tax returns in many jurisdictions throughout the world and are subject to income tax examinations for our fiscal year 2015 and subsequent years, with certain exceptions. While we believe that our tax return positions are fully supported, tax authorities may disagree with certain positions we have taken and assess additional taxes and as a result, we may
Foreign Currency	Foreign Currency Our functional currency is the U.S. dollar; however, a portion of the revenues earned and expenses incurred by certain of our subsidiaries are denominated in currencies other than the U.S. dollar. We determine the functional currency of our subsidiaries that exist and operate in different economic and currency environments based on the primary economic environment in which the subsidiary operates, that is, the currency of the environment in which an entity primarily generates and expends cash. Our significant foreign subsidiaries are located in Europe and the U.S. The functional currency of our significant European subsidiaries is the Euro, and the functional currency of our significant U.S. subsidiaries is the U.S. dollar. Assets and liabilities of subsidiaries whose functional currency is not the U.S. dollar are translated into U.S. dollars based on a combination of both current and historical exchange rates, while their revenues earned and expenses incurred are translated into U.S. dollars at average period exchange rates. Translation adjustments are included as AOCI on the consolidated balance sheets. Gains and losses arising from transactions denominated in a currency different from an entity’s functional currency are included in foreign exchange and other income/(expense) on our consolidated statements of income (loss). Taxes are not provided on cumulative translation adjustments, as substantially all translation adjustments are related to earnings which are intended to be indefinitely reinvested in the countries where earned.
Contingencies	Contingencies We are subject to product liability claims, environmental obligations, government investigations and other legal proceedings in the ordinary course of business. Legal fees and other expenses related to litigation are expensed as incurred and included in selling, general and administrative expenses on our consolidated statements of income (loss). Contingent liabilities are recorded when we determine that a loss is both probable and reasonably estimable. Due to the fact that legal proceedings and other contingencies are inherently unpredictable, our assessments involve significant judgment regarding future events.
Restructuring	We initiate restructuring plans to leverage economies of scale, streamline distribution and logistics, and strengthen operational and administrative effectiveness in order to reduce overall costs.

Business Combinations (Tables)

Business Combinations (Tables)	12 Months Ended
	Dec. 31, 2022
Business Combination and Asset Acquisition [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 ALung prior to the acquisition, including certain measurement period adjustments (in thousands): Initial Fair Value of Consideration Measurement Period Adjustments (1) Adjusted Fair Value of Consideration Cash and other considerations $ 15,586 $ — $ 15,586 Contingent consideration 26,369 (9,578) 16,791 Fair value of consideration transferred $ 41,955 $ (9,578) $ 32,377 (1) During the third quarter of 2022, measurement period adjustments were recorded based on information obtained about facts and circumstances that existed as of the acquisition date.
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table presents the preliminary purchase price allocation at fair value for the ALung acquisition, including certain measurement period adjustments (in thousands): Initial Purchase Price Allocation Measurement Period Adjustments (1) Adjusted Purchase Price Allocation Developed technology - 15-year life $ 13,950 $ (11,050) $ 2,900 Goodwill 25,893 977 26,870 Other assets and liabilities, net 2,112 495 2,607 Net assets acquired $ 41,955 $ (9,578) $ 32,377 (1) During the third quarter of 2022, measurement period adjustments were recorded based on information obtained about facts and circumstances that existed as of the acquisition date.
Significant Unobservable Inputs Related to Contingent Consideration	The sales-based earnout was valued using projected sales from our internal strategic plan and is a Level 3 fair value measurement, which includes the following significant unobservable inputs (in thousands): ALung Acquisition Fair value at May 2, 2022 Valuation Technique Unobservable Input Ranges Sales-based earnout $ 16,791 Monte Carlo simulation Risk-adjusted discount rate 7.0% - 8.4% Credit risk discount rate 6.4% - 8.0% Revenue volatility 25.7% Projected years of earnout 2023 - 2027 ImThera Acquisition Valuation Technique Unobservable Input Inputs Regulatory milestone-based payment Discounted cash flow Discount rate 10.5% Probability of payment 85% Projected payment year 2025 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 14.3% - 14.6% Credit risk discount rate 10.8% - 11.4% Revenue volatility 32.5% Probability of payment 85% Projected years of earnout 2026 - 2029 The ALung business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain sales-based thresholds associated with sales of products. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs as of December 31, 2022: ALung Acquisition Valuation Technique Unobservable Input Inputs Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 9.7% - 10.3% Credit risk discount rate 10.0% - 11.1% Revenue volatility 28.9% Projected years of earnout 2023 - 2027 The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The probability of payment for the final regulatory milestone was reduced to 0% during the year ended December 31, 2022.

Restructuring (Tables)

Restructuring (Tables)	12 Months Ended
	Dec. 31, 2022
Restructuring and Related Activities [Abstract]
Reconciliation of Accruals and Other Reserves Related to Restructuring	The following table presents a reconciliation of the beginning and ending balance of the accruals and other reserves recorded in connection with our restructuring plans included within accrued liabilities and other long-term liabilities on the consolidated balance sheet for the years ended December 31, 2022, 2021 and 2020 (in thousands): Employee Severance and Other Termination Costs Other Total As of December 31, 2019 $ 4,097 $ 1,400 $ 5,497 Charges 7,571 — 7,571 Cash payments (5,919) (854) (6,773) As of December 31, 2020 5,749 546 6,295 Charges 7,963 1,750 9,713 Cash payments (12,876) (2,296) (15,172) As of December 31, 2021 836 — 836 Charges 6,611 — 6,611 Cash payments (5,402) — (5,402) As of December 31, 2022 (1) $ 2,045 $ — $ 2,045 (1) Cumulative restructuring expense, inclusive of discontinued operations, since the merger of Cyberonics, Inc. and Sorin S.p.A. (“Sorin”) in October 2015 totaled $135.4 million as of December 31, 2022.
Schedule of Restructuring Expense by Reportable Segment	The following table presents restructuring expense by reportable segment for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary $ 697 $ 2,844 $ 1,040 Neuromodulation 2,651 1,531 3,223 Advanced Circulatory Support 1,999 — — Other 1,264 5,338 3,308 Total (1) $ 6,611 $ 9,713 $ 7,571 (1) Restructuring expense is included within other operating expenses on the consolidated statements of income (loss).

Product Remediation Liability (

Product Remediation Liability (Tables)	12 Months Ended
	Dec. 31, 2022
Loss Contingency [Abstract]
Schedule of Product Remediation	The following table presents the changes in the product remediation liability for the years ended December 31, 2022, 2021 and 2020 (in thousands): As of December 31, 2019 $ 3,251 Adjustments 3,199 Remediation activity (5,743) Effect of changes in foreign currency exchange rates 349 As of December 31, 2020 1,056 Adjustments 712 Remediation activity (880) Effect of changes in foreign currency exchange rates (81) As of December 31, 2021 807 Remediation activity (15) Effect of changes in foreign currency exchange rates (47) As of December 31, 2022 $ 745

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Finite-lived and Indefinite-lived Intangible Assets	The following table presents our finite-lived and indefinite-lived intangible assets as of December 31, 2022 and 2021 (in thousands): 2022 2021 Finite-lived intangible assets: Customer relationships $ 184,397 $ 192,800 Developed technology 217,205 219,706 Trade names 24,368 25,154 Other intangible assets 756 616 Total gross finite-lived intangible assets 426,726 438,276 Accumulated amortization - Customer relationships 72,820 65,106 Accumulated amortization - Developed technology 80,219 68,488 Accumulated amortization - Trade names 16,483 16,500 Accumulated amortization - Other intangible assets 651 506 Total accumulated amortization 170,173 150,600 Net finite-lived intangible assets $ 256,553 $ 287,676 Indefinite-lived intangible assets: IPR&D $ 112,006 $ 112,006 Goodwill 768,787 899,525 Total indefinite-lived intangible assets $ 880,793 $ 1,011,531
Schedule of Amortization Periods for Finite-lived Intangible Assets	The following table presents the amortization periods for our finite-lived intangible assets as of December 31, 2022: Minimum Life in years Maximum Life in years Customer relationships 8 18 Developed technology 14 17 Trade names 15 15
Schedule of Finite-lived Intangible Assets Estimated Future Amortization Expense	The following table presents the estimated future amortization expense based on our finite-lived intangible assets as of December 31, 2022 (in thousands): 2023 $ 25,372 2024 25,372 2025 25,372 2026 25,372 2027 24,957 Thereafter 130,108 Total $ 256,553
Schedule of Goodwill Carrying Amounts	The following table presents the changes in the carrying amount of goodwill by reportable segment for the years ended December 31, 2022, 2021 and 2020 (in thousands): Cardiopulmonary Neuromodulation Advanced Circulatory Support Other (1) Total As of December 31, 2019 $ 394,735 $ 398,754 $ 102,526 $ 19,779 $ 915,794 Impairment (2) — — — (21,269) (21,269) Foreign currency adjustments 26,303 — — 1,490 27,793 As of December 31, 2020 421,038 398,754 102,526 — 922,318 Foreign currency adjustments (22,793) — — — (22,793) As of December 31, 2021 398,245 398,754 102,526 — 899,525 Goodwill as a result of acquisition (3) — — 25,893 — 25,893 Measurement period adjustments — — 977 — 977 Impairment (4) — — (129,396) — (129,396) Foreign currency adjustments (28,212) — — — (28,212) As of December 31, 2022 $ 370,033 $ 398,754 $ — $ — $ 768,787 (1) Other includes goodwill associated the Company’s Heart Valve business, which was divested on June 1, 2021. (2) During the year ended December 31, 2020, the Company recognized a $21.3 million impairment of goodwill allocated to Heart Valves. Refer to “Note 5. Divestiture of Heart Valve Business” for additional information. (3) Refer to “Note 4. Business Combinations” for additional information.

Investments (Tables)

Investments (Tables)	12 Months Ended
	Dec. 31, 2022
Investments [Abstract]
Schedule of Long-Term Investments	These below equity investments are included in investments on the consolidated balance sheets as of December 31, 2022 and 2021 (in thousands): 2022 2021 ShiraTronics, Inc. $ 5,000 $ 3,331 Noctrix Health, Inc. 3,159 3,159 Ceribell, Inc. 3,000 3,000 MD Start II (1) 1,069 1,135 Rainbow Medical Ltd. 1,047 1,111 Highlife S.A.S. 1,013 1,075 ALung Technologies, Inc. (2) — 3,000 14,288 15,811 Equity method investment (3) 1,978 787 $ 16,266 $ 16,598 (1) During the second quarter of 2021 the Company received a cash dividend from its investment in MD Start II of $3.1 million, which is included in “Foreign exchange and other income/(expense)” on the consolidated statements of income (loss) for the year ended December 31, 2022. (2) As of December 31, 2021, LivaNova owned a 3% equity interest in ALung with a carrying value of $3.0 million, as well as held a note receivable due from ALung with a carrying value of $2.5 million. On May 2, 2022, we acquired the remaining 97% of equity interests in ALung. Please refer to “Note 4. Business Combinations” for further details. (3) As of December 31, 2022, we are required to fund follow-on investments up to approximately €3.0 million (approximately $3.2 million as of December 31, 2022) based on cash calls.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Schedule of Fair Value of Assets and Liabilities Measured on a Recurring Basis	The following tables present information by level for assets and liabilities that are measured at fair value on a recurring basis as of December 31, 2022 and 2021 (in thousands): 2022 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets Derivative assets - designated as cash flow hedges (interest rate swaps) $ 1,333 $ — $ 1,333 $ — Derivative assets - capped call derivatives 54,393 — — 54,393 Convertible notes receivable 285 — — 285 $ 56,011 $ — $ 1,333 $ 54,678 Liabilities Derivative liabilities - freestanding instruments (foreign currency exchange rate “ FX ” ) $ 5,886 $ — $ 5,886 $ — Derivative liabilities - embedded exchange feature 85,675 — — 85,675 Contingent consideration arrangements 85,292 — — 85,292 $ 176,853 $ — $ 5,886 $ 170,967 2021 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets Derivative assets - designated as cash flow hedges (FX) $ 243 $ — $ 243 $ — Derivative assets - freestanding instruments (FX) 61 — 61 — Derivative assets - capped call derivatives 106,629 — — 106,629 Convertible notes receivable 2,767 — — 2,767 $ 109,700 $ — $ 304 $ 109,396 Liabilities Derivative liabilities - designated as cash flow hedges (FX) $ 1,286 $ — $ 1,286 $ — Derivative liabilities - freestanding instruments (FX) 427 — 427 — Derivative liabilities - embedded exchange feature 181,700 — — 181,700 Contingent consideration arrangements 98,382 — — 98,382 $ 281,795 $ — $ 1,713 $ 280,082
Schedule of Recurring Fair Value Measurements Using Significant Unobservable Inputs	The following table presents a reconciliation of the beginning and ending balances of our recurring fair value measurements, using significant unobservable inputs (Level 3) for the years ended December 31, 2022, 2021 and 2020 (in thousands): Capped Call Derivative Asset Convertible Notes Receivable Embedded Exchange Feature Derivative Liability Other Derivative Liabilities Contingent Consideration Liability Arrangements As of December 31, 2020 $ 72,302 $ 2,775 $ 121,756 $ 4,290 $ 103,818 Payments (1) — — — — (6,000) Changes in fair value (2) (3) 34,327 (8) 59,944 (4,290) 564 As of December 31, 2021 106,629 2,767 181,700 — 98,382 Additions — — — — 26,369 Utilized as business combination consideration — (2,495) — — — Measurement period adjustments (4) — — — — (9,578) Changes in fair value (2) (3) (5) (52,236) 13 (96,025) — (29,881) As of December 31, 2022 - long-term $ 54,393 $ 285 $ 85,675 $ — $ 85,292 (1) During the year ended December 31, 2021, we paid $6.0 million under the contingent consideration arrangement for the acquisition of Miami Instruments, LLC. (2) During the year ended December 31, 2022, the contingent consideration change in fair value resulted in a decrease of $10.5 million recorded to cost of sales R&D cost of sales R&D (3) Changes in the fair value of the embedded exchange feature derivative, capped call derivatives and other derivative liabilities are recognized in foreign exchange and other income/(expense) in the consolidated statements of income (loss). See the below section titled “ Embedded Exchange Feature and Capped Call Derivatives” for further information on the changes in fair value as it relates to the embedded exchange feature and capped call derivatives. (4) For further details refer to “Note 4. Business Combinations.”
Schedule of Fair Value of Contingent Consideration by Acquisition	The following table presents the fair value of our Level 3 contingent consideration arrangements by acquisition as of December 31, 2022 and 2021 (in thousands): 2022 2021 ImThera $ 69,389 $ 86,830 ALung 15,903 — TandemLife — 11,552 $ 85,292 $ 98,382
Significant Unobservable Inputs Related to Contingent Consideration	The sales-based earnout was valued using projected sales from our internal strategic plan and is a Level 3 fair value measurement, which includes the following significant unobservable inputs (in thousands): ALung Acquisition Fair value at May 2, 2022 Valuation Technique Unobservable Input Ranges Sales-based earnout $ 16,791 Monte Carlo simulation Risk-adjusted discount rate 7.0% - 8.4% Credit risk discount rate 6.4% - 8.0% Revenue volatility 25.7% Projected years of earnout 2023 - 2027 ImThera Acquisition Valuation Technique Unobservable Input Inputs Regulatory milestone-based payment Discounted cash flow Discount rate 10.5% Probability of payment 85% Projected payment year 2025 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 14.3% - 14.6% Credit risk discount rate 10.8% - 11.4% Revenue volatility 32.5% Probability of payment 85% Projected years of earnout 2026 - 2029 The ALung business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain sales-based thresholds associated with sales of products. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs as of December 31, 2022: ALung Acquisition Valuation Technique Unobservable Input Inputs Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 9.7% - 10.3% Credit risk discount rate 10.0% - 11.1% Revenue volatility 28.9% Projected years of earnout 2023 - 2027 The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The probability of payment for the final regulatory milestone was reduced to 0% during the year ended December 31, 2022.

Financing Arrangements (Tables)

Financing Arrangements (Tables)	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Schedule of Long-term Debt	The following table presents the outstanding principal amounts of our long-term debt facilities as of December 31, 2022 and 2021 (in thousands, except interest rates): 2022 2021 Maturity Interest Rate Term Facilities $ 289,294 $ — July 2027 7.21% 2020 Cash Exchangeable Senior Notes 239,568 225,140 December 2025 3.00% Bank of America Merrill Lynch Banco Múltiplo S.A. 6,462 6,113 July 2023 16.20% Mediocredito Italiano 1,601 3,379 December 2023 0.50% - 3.47% Bank of America, U.S. 1,500 1,500 January 2023 5.45% Other 534 663 Total long-term facilities 538,959 236,795 Less current portion of long-term debt 20,892 226,946 Total long-term debt obligations $ 518,067 $ 9,849
Schedule of Maturities of Long-term Debt	ontractual annual principal maturities of our long-term debt facilities as of December 31, 2022 (in thousands): 2023 $ 20,914 2024 15,092 2025 306,301 2026 26,310 2027 226,875 Thereafter 252 Total payments 595,744 Less: Debt issuance costs (56,785) Total long-term facilities $ 538,959

Derivatives and Risk Manageme_2

Derivatives and Risk Management (Tables)	12 Months Ended
	Dec. 31, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Notional Amounts of Outstanding Derivative Positions	The following table presents the gross notional amounts of open derivative contracts designated as cash flow hedges as of December 31, 2022 and 2021 (in thousands): Description of Derivative Contract 2022 2021 FX derivative contracts to be exchanged for British Pounds $ — $ 11,160 FX derivative contracts to be exchanged for Japanese Yen — 6,648 FX derivative contracts to be exchanged for Euros — 58,224 Interest rate swap contracts 210,000 — $ 210,000 $ 76,032
Schedule of Cash Flow Hedges Included in AOCI	The following table presents the after-tax net (loss) gain 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 12 months as of December 31, 2022 (in thousands): Description of Derivative Contract After-tax Net Gain in AOCI After-tax Net Gain Expected to be Reclassified to Earnings in Next 12 Months Interest rate swap contracts $ 966 $ 966 The following tables present the pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in OCI and the amount reclassified to earnings from AOCI for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss (Loss) Gain Recognized in OCI Loss Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other income/(expense) $ (4,602) $ (382) FX derivative contracts SG&A — (5,165) Interest rate swap contracts Interest expense 914 (52) $ (3,688) $ (5,599) 2021 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Loss Recognized in OCI (Loss) Gain Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other income/(expense) $ (3,922) $ (2,333) FX derivative contracts SG&A — 2,408 $ (3,922) $ 75 2020 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gain Recognized in OCI (Loss) Gain Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other income/(expense) $ 1,724 $ (1,522) FX derivative contracts SG&A — 980 Interest rate swap contracts Interest expense — (113) $ 1,724 $ (655)
Schedule of Fair Value of Derivative Instruments in Statement of Financial Position	The following tables present the fair value and the location of derivative contracts reported on the consolidated balance sheets as of December 31, 2022 and 2021 (in thousands): 2022 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 Current derivative assets $ 1,333 Total derivatives designated as hedging instruments 1,333 Derivatives Not Designated as Hedging Instruments FX derivative contracts Current derivative liabilities $ 5,886 Capped call derivatives Long-term derivative assets 54,393 Embedded exchange feature Long-term derivative liabilities 85,675 Total derivatives not designated as hedging instruments 54,393 91,561 Total derivatives $ 55,726 $ 91,561 2021 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) FX derivative contracts Current derivative liabilities $ 243 Current derivative liabilities $ 1,286 Total derivatives designated as hedging instruments 243 1,286 Derivatives Not Designated as Hedging Instruments FX derivative contracts Current derivative liabilities 61 Current derivative liabilities 427 Capped call derivatives Current derivative assets 106,629 Embedded exchange feature Current derivative liabilities 181,700 Total derivatives not designated as hedging instruments 106,690 182,127 Total derivatives $ 106,933 $ 183,413 (1) For the classification of inputs used to evaluate the fair value of our derivatives, refer to “Note 10. Fair Value Measurements.”

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2022
Leases [Abstract]
Components of Operating Lease Assets and Liabilities	he components of operating lease assets and liabilities as of December 31, 2022 and 2021 (in thousands): 2022 2021 Assets Operating lease right-of-use assets $ 35,830 $ 40,600 Liabilities Accrued liabilities and other $ 9,379 $ 11,261 Long-term operating lease liabilities 29,548 35,919 Total lease liabilities $ 38,927 $ 47,180
Components of Operating Lease Costs	2022 2021 2020 Operating lease cost $ 10,408 $ 18,070 $ 14,156 Variable lease cost 580 1,200 1,097 Short-term lease cost 468 1,084 415 Total lease cost $ 11,456 $ 20,354 $ 15,668 2022 2021 Weighted Average Remaining Lease Term 6.5 years 5.8 years Weighted Average Discount Rate 3.9% 3.2% The following table presents the supplemental lease information for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 12,468 $ 13,650 $ 14,601 Operating lease assets obtained in exchange for lease liabilities $ 7,820 $ 9,037 $ 8,547
Contractual Maturities of Lease Liabilities	ontractual maturities of our lease liabilities as of December 31, 2022 (in thousands): 2023 $ 10,520 2024 8,095 2025 5,372 2026 3,998 2027 3,570 Thereafter 12,747 Total lease payments 44,302 Less: Amount representing interest 5,375 Present value of lease liabilities $ 38,927 The following table presents the weighted average remaining lease term and discount rate as of December 31, 2022 and 2021:
Schedule of Lease Terms, Discount Rates, and Cash Flow Information	2022 2021 2020 Operating lease cost $ 10,408 $ 18,070 $ 14,156 Variable lease cost 580 1,200 1,097 Short-term lease cost 468 1,084 415 Total lease cost $ 11,456 $ 20,354 $ 15,668 2022 2021 Weighted Average Remaining Lease Term 6.5 years 5.8 years Weighted Average Discount Rate 3.9% 3.2% The following table presents the supplemental lease information for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 12,468 $ 13,650 $ 14,601 Operating lease assets obtained in exchange for lease liabilities $ 7,820 $ 9,037 $ 8,547

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Schedule of Loss Contingencies by Contingency	The following table presents the changes in the carrying amount of the litigation provision liability for the years ended December 31, 2022, 2021 and 2020 (in thousands): As of December 31, 2019 $ 170,404 Payments (138,178) Adjustments (1) 3,906 FX and other 358 As of December 31, 2020 36,490 Payments (34,808) Adjustments (1) 38,068 FX and other (280) As of December 31, 2021 39,470 Payments (28,867) Adjustments (1) 22,309 FX and other (425) As of December 31, 2022 32,487 Less current portion as of December 31, 2022 29,481 Long-term portion as of December 31, 2022 (2) $ 3,006 (1) Adjustments to the litigation provision are included within other operating expenses on the consolidated statements of income (loss). (2) Included within other long-term liabilities on the consolidated balance sheet.

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2022
Stockholders' Equity Note [Abstract]
Schedule of Accumulated Other Comprehensive Income (Loss)	The following table presents the change in each component of AOCI, net of tax and the reclassifications out of AOCI into net loss for the years ended December 31, 2022, 2021 and 2020 (in thousands): Change in Unrealized Gain (Loss) on Cash Flow Hedges Foreign Currency Translation Adjustments (1) Total As of December 31, 2019 $ 513 $ (19,905) $ (19,392) Other comprehensive income before reclassifications, before tax 1,724 45,395 47,119 Tax expense (415) — (415) Other comprehensive income before reclassifications, net of tax 1,309 45,395 46,704 Reclassification of loss from accumulated other comprehensive income (loss), before tax 655 — 655 Reclassification of tax benefit (158) — (158) Reclassification of loss from accumulated other comprehensive income (loss), after tax 497 — 497 Net current-period other comprehensive income, net of tax 1,806 45,395 47,201 As of December 31, 2020 2,319 25,490 27,809 Other comprehensive loss before reclassifications, before tax (3,922) (31,722) (35,644) Tax benefit 719 — 719 Other comprehensive loss before reclassifications, net of tax (3,203) (31,722) (34,925) Reclassification of gain from accumulated other comprehensive income (loss), before tax (75) — (75) Reclassification of tax expense 14 — 14 Reclassification of gain from accumulated other comprehensive income (loss), after tax (61) — (61) Net current-period other comprehensive loss, net of tax (3,264) (31,722) (34,986) As of December 31, 2021 (945) (6,232) (7,177) Other comprehensive income before reclassifications, before tax (3,688) (42,853) (46,541) Tax benefit — — — Other comprehensive income before reclassifications, net of tax (3,688) (42,853) (46,541) Reclassification of gain from accumulated other comprehensive income (loss), before tax 5,599 — 5,599 Reclassification of tax expense — — — Reclassification of gain from accumulated other comprehensive income (loss), after tax 5,599 — 5,599 Net current-period other comprehensive income (loss), net of tax 1,911 (42,853) (40,942) As of December 31, 2022 $ 966 $ (49,085) $ (48,119)

Stock-Based Plans (Tables)

Stock-Based Plans (Tables)	12 Months Ended
	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Schedule of Allocation of Share Based Compensation Costs by Expense Category	The following table presents the amounts of stock-based compensation recognized on our consolidated statements of income (loss), by expense category for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cost of goods sold $ 1,455 $ 2,451 $ 1,898 Selling, general and administrative 35,638 29,449 29,661 Research and development 7,716 8,664 3,530 Total stock-based compensation expense 44,809 40,564 35,089 Income tax benefit 706 588 992 Total expense, net of income tax benefit $ 44,103 $ 39,976 $ 34,097
Schedule of Allocation of Share-Based Compensation Costs by Type of Arrangement	The following table presents the amounts of stock-based compensation expense recognized on our consolidated statements of income (loss) by type of arrangement for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Service-based restricted stock units $ 21,563 $ 19,614 $ 18,320 Service-based stock appreciation rights 14,065 12,489 12,715 Market performance-based restricted stock units 4,651 3,522 3,200 Operating performance-based restricted stock units 3,338 3,434 (370) Employee stock purchase plan 1,192 1,505 1,224 Total stock-based compensation expense $ 44,809 $ 40,564 $ 35,089
Schedule of Stock-Based Compensation Costs Unrecognized	The following table presents the amounts of stock-based compensation cost not yet recognized related to non-vested awards, including awards assumed or issued as of December 31, 2022 (in thousands): Unrecognized Compensation Cost Weighted Average Remaining Vesting Period (in years) Service-based stock appreciation rights $ 25,886 2.61 Service-based restricted stock unit awards 33,823 2.49 Performance-based restricted stock unit awards 9,922 1.74 Total stock-based compensation cost unrecognized $ 69,631 2.28
Schedule of Stock Options Valuation Assumptions	The following table lists the assumptions we utilized as inputs to the Black-Scholes model for the years ended December 31, 2022, 2021 and 2020: 2022 2021 2020 Dividend yield (1) — — — Risk-free interest rate (2) 2.5% 1.0% 0.4% Expected option term - in years (3) 5.3 5.6 5.4 Expected volatility at grant date (4) 42.2% 42.1% 39.5% (1) We have not paid dividends and no future dividends have been approved. (2) We use yield rates on U.S. Treasury securities for a period that approximates the expected term of the awards granted to estimate the risk-free interest rate. (3) We estimated the expected term of the awards granted using historic data of actual time elapsed between the date of grant and the exercise or forfeiture of options or SARs for employees. (4) We determine the expected volatility of the awards based on historical volatility.
Schedule of Stock Option Activity	The following tables present the activity for service-based SARs and stock option awards: SARs and Stock Options Number of Optioned Shares Wtd. Avg. Exercise Price per Share Wtd. Avg. Remaining Contractual Term (years) Aggregate Intrinsic Value (in thousands) (1) Outstanding — as of December 31, 2021 2,634,373 $ 65.94 Granted 553,050 $ 82.04 Exercised (93,191) $ 48.86 Forfeited (150,881) $ 67.46 Expired (136,515) $ 89.41 Outstanding — as of December 31, 2022 2,806,836 $ 68.46 6.67 $ 10,070 Fully vested and exercisable — end of year 1,460,162 $ 67.43 5.24 $ 5,494 Fully vested and expected to vest — end of year (2) 2,756,467 $ 68.35 6.64 $ 9,979 (1) The aggregate intrinsic value of SARs and options is based on the difference between the fair market value of the underlying stock at December 31, 2022, using the market closing stock price, and exercise price for in-the-money awards. (2) Includes the impact of expected future forfeitures. Year Ended December 31, 2022 2021 2020 Weighted average grant date fair value of SARs granted during the year (per share) $ 34.13 $ 29.22 $ 15.73 Aggregate intrinsic value of SARs and stock options exercised during the year (in thousands) $ 2,143 $ 12,223 $ 773
Summary of Restricted Stock Service-Based Activity	The following tables present the activity for service-based RSU awards: RSUs Number of Shares Wtd. Avg. Grant Date Fair Value Non-vested shares as of December 31, 2021 791,157 $ 64.53 Granted 328,980 $ 76.35 Vested (298,865) $ 68.11 Forfeited (79,380) $ 64.85 Non-vested shares as of December 31, 2022 741,892 $ 68.02 Year Ended December 31, 2022 2021 2020 Weighted average grant date fair value of service-based RSUs issued during the year (per share) $ 76.35 $ 74.17 $ 44.28 Aggregate fair value of RSUs that vested during the year (in thousands) $ 22,793 $ 21,501 $ 13,674
Summary of Performance-Based Restricted Stock and Restricted Stock Unit Activity	The following tables present the activity for performance-based RSU awards: Performance-based RSUs Number of Shares Wtd. Avg. Grant Date Fair Value Non-vested shares as of December 31, 2021 345,944 $ 68.36 Granted 88,354 $ 92.53 Vested (11,340) $ 95.13 Forfeited (11,474) $ 41.70 Performance adjustments (1) (80,950) $ 91.58 Non-vested shares as of December 31, 2022 330,534 $ 70.45 (1) Represents the difference between the target units granted and the actual units awarded based upon the attainment of performance goals for the Company. Year Ended December 31, 2022 2021 2020 Weighted average grant date fair value of performance-based restricted share units granted during the year (per share) $ 92.53 $ 89.29 $ 41.70 Aggregate fair value of performance-based restricted share units that vested during the year (in thousands) $ 877 $ 8,268 $ 4,106

Employee Retirement Plans (Tabl

Employee Retirement Plans (Tables)	12 Months Ended
	Dec. 31, 2022
Retirement Benefits [Abstract]
Schedule of Change in Benefit Obligations and Funded Status	The following table presents the change in benefit obligations and funded status of our U.S. pension benefits for the years ended December 31, 2022, 2021 and 2020 (in thousands): U.S. Pension Benefits 2022 2021 2020 Accumulated benefit obligations at year end $ 9,790 $ 12,578 $ 13,085 Change in projected benefit obligation: Projected benefit obligation at beginning of year $ 12,578 $ 13,085 $ 11,232 Interest cost 254 224 290 Plan settlement (1,369) (972) (384) Actuarial (gain)/loss (1,361) 527 2,225 Benefits paid (312) (286) (278) Projected benefit obligation at end of year $ 9,790 $ 12,578 $ 13,085 Change in plan assets: Fair value of plan assets at beginning of year $ 8,020 $ 8,688 $ 7,574 Actual return on plan assets (1,189) 189 646 Employer contributions 367 401 1,130 Plan settlement (1,369) (972) (384) Benefits paid (313) (286) (278) Fair value of plan assets at end of year $ 5,516 $ 8,020 $ 8,688 Funded status at end of year: Fair value of plan assets $ 5,516 $ 8,020 $ 8,688 Projected benefit obligations 9,790 12,578 13,085 Underfunded status of the plans 4,274 4,558 4,397 Recognized liability $ 4,274 $ 4,558 $ 4,397 Amounts recognized on the consolidated balance sheets consist of: Non-current liabilities $ 4,274 $ 4,558 $ 4,397 Recognized liability $ 4,274 $ 4,558 $ 4,397 The following table presents the change in benefit obligations and funded status of our non-U.S. pension benefits for the years ended December 31, 2022, 2021 and 2020 (in thousands): Non-U.S. Pension Benefits 2022 2021 2020 Accumulated benefit obligations at year end $ 8,248 $ 10,522 $ 12,091 Change in projected benefit obligation: Projected benefit obligation at beginning of year $ 10,817 $ 13,039 $ 18,087 Service cost 259 354 691 Interest cost 83 56 121 Actuarial gain (831) (1,372) (208) Benefits paid (1,060) (294) (1,245) Reclassified to liabilities held for sale (1) — — (6,012) Foreign currency exchange rate changes and other (736) (966) 1,605 Projected benefit obligation at end of year $ 8,532 $ 10,817 $ 13,039 Change in plan assets: Fair value of plan assets at beginning of year $ 3,142 $ 2,816 $ 3,423 Actual return on plan assets (80) 61 52 Employer contributions 265 302 454 Benefits paid (37) (78) (290) Reclassified to liabilities held for sale (1) — — (1,018) Foreign currency exchange rate changes and other (58) 41 195 Fair value of plan assets at end of year $ 3,232 $ 3,142 $ 2,816 Funded status at end of year: Fair value of plan assets $ 3,232 $ 3,142 $ 2,816 Projected benefit obligations 8,532 10,817 13,039 Underfunded status of the plans (2) 5,300 7,675 10,223 Recognized liability $ 5,300 $ 7,675 $ 10,223 Amounts recognized on the consolidated balance sheets consist of: Non-current liabilities $ 5,300 $ 7,675 $ 10,223 Recognized liability $ 5,300 $ 7,675 $ 10,223 (1) Refer to “Note 5. Divestiture of Heart Valve Business.” (2) In certain non-U.S. countries, fully funding pension plans is not a common practice. Consequently, certain pension plans have been partially funded.
Schedule of Net Periodic Benefit Cost of the Plans	The following tables present U.S. and non-U.S. net periodic benefit cost of the defined benefit pension plans by component for the years ended December 31, 2022, 2021 and 2020 (in thousands): U.S. Pension Benefits 2022 2021 2020 Interest cost $ 254 $ 224 $ 290 Expected return on plan assets (298) (358) (318) Settlement and curtailment loss 731 471 180 Amortization of net actuarial loss 262 264 182 Net periodic benefit cost $ 949 $ 601 $ 334 Non-U.S. Pension Benefits 2022 2021 2020 Service cost $ 259 $ 354 $ 691 Interest cost 83 56 121 Expected return on plan assets 80 (61) (52) Amortization of net actuarial loss (gain) (831) (1,372) (208) Net periodic benefit cost $ (409) $ (1,023) $ 552
Schedule of Assumptions Used	The following table presents the major actuarial assumptions used in determining the benefit obligations and net periodic benefit cost for our significant U.S. benefit plans as of December 31, 2022, 2021 and 2020: U.S. Pension Benefits 2022 2021 2020 Weighted-average assumptions used to determine benefit obligation: Discount rate 5.10% 2.41% 1.91% Weighted-average assumptions used to determine net periodic benefit cost: Discount rate 2.41% 1.91% 2.88% Expected return on plan assets 5.00% 5.00% 5.00% The following table presents the major actuarial assumptions used in determining the benefit obligations and net periodic benefit cost for our significant non-U.S. benefit plans as of December 31, 2022, 2021 and 2020: Non-U.S. Pension Benefits 2022 2021 2020 Weighted-average assumptions used to determine benefit obligation: Discount rate 0.45% - 3.70% 0.15% - 1.00% 0.23% - 0.35% Rate of compensation increase 2.50% - 3.50% 2.50% - 3.00% 2.50% - 3.00% Weighted-average assumptions used to determine net periodic benefit cost: Discount rate 0.45% - 3.70% 0.15% - 1.00% 0.23% - 0.35% Rate of compensation increase 2.50% - 3.50% 2.50% - 3.00% 2.50% - 3.00%
Schedule of Target Asset Allocation	The following table presents our U.S. pension plan target allocations by asset category as of December 31, 2022: Equity securities 29% Debt securities 70% Other 1%
Schedule of Fair Value of Retirement Benefit Plan Assets	The following tables present information by level for the retirement benefit plan assets that are measured at fair value on a recurring basis as of December 31, 2022 and 2021 (in thousands): 2022 Fair Value Measurement Using Inputs Considered as: Level 1 Level 2 Level 3 Equity mutual funds $ 1,591 $ — $ 1,591 $ — Fixed income mutual funds 3,843 — 3,843 — Money market funds and cash 68 68 — — $ 5,502 $ 68 $ 5,434 $ — 2021 Fair Value Measurement Using Inputs Considered as: Level 1 Level 2 Level 3 Equity mutual funds $ 2,341 $ — $ 2,341 $ — Fixed income mutual funds 5,587 — 5,587 — Money market funds 82 82 — — $ 8,010 $ 82 $ 7,928 $ —
Schedule of Expected Benefit Payments	enefit payments expected to be paid, including amounts to be paid from our assets, and reflecting expected future service, as of December 31, 2022 (in thousands): U.S. Plans Non-U.S. Plans 2023 3,820 740 2024 688 589 2025 853 675 2026 908 634 2027 673 730 2028 - 2032 2,196 3,769

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Schedule of Components of and Provision for Income Taxes	The following table presents the U.S. and non-U.S. components of income (loss) from continuing operations before income taxes and our income tax expense (benefit) from continuing operations for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Income (loss) from continuing operations before income taxes: Non-U.S. $ 22,570 $ 22,094 $ (262,501) U.S. (97,712) (146,566) (85,521) $ (75,142) $ (124,472) $ (348,022) Total income tax expense (benefit) from continuing operations consisted of the following: Current: Non-U.S. $ 4,782 $ 4,296 $ 2,899 U.S. 4,860 4,050 (41,010) 9,642 8,346 (38,111) Deferred: Non-U.S. 1,409 2,852 37,151 Total income tax expense (benefit) from continuing operations $ 11,051 $ 11,198 $ (960)
Schedule of Effective Income Tax Rate Reconciliation	The following table presents a reconciliation of the statutory income tax rate to our effective income tax rate expressed as a percentage of income from continuing operations before income taxes for the years ended December 31, 2022, 2021 and 2020: 2022 2021 2020 Statutory tax rate at UK Rate 19.0 % 19.0 % 19.0 % Deferred tax valuation allowance (18.8) (47.7) (34.9) Foreign tax rate differential 10.6 7.1 6.6 U.S. state and local tax expense, net of federal benefit (1.4) (0.3) 1.5 Effect of changes in tax rate 6.2 18.9 2.2 Write-off/impairment of investments (27.6) (1.8) 1.8 Reserve for uncertain tax positions — — 0.8 Research and development tax credits 1.2 0.3 0.9 Base erosion anti-abuse tax (2.9) (3.1) (0.7) Foreign tax withholding and credits — (0.2) (0.2) CARES Act rate differential — — 2.8 Disallowable professional fees (0.4) (1.5) — Other, net (0.6) 0.3 0.5 Effective tax rate (14.7) % (9.0) % 0.3 %
Schedule of Significant Components of Deferred Tax Assets and Liabilities	The following table presents the significant components of our deferred tax assets and liabilities as of December 31, 2022 and 2021 (in thousands): 2022 2021 Deferred tax assets: Net operating loss carryforwards $ 142,456 $ 152,491 Tax credit carryforwards 41,918 40,931 Interest expense carryforward 65,497 65,141 Accruals and reserves 35,132 36,796 Deferred compensation 16,081 13,262 Inventories 9,073 8,844 Deferred R&D 29,796 — Other 6,898 19,119 Gross deferred tax assets 346,851 336,584 Valuation allowance (264,754) (244,978) Net deferred tax assets 82,097 91,606 Deferred tax liabilities: Property, equipment & intangible assets (76,419) (70,573) Gain on sale of intellectual property (12,810) (26,564) Gross deferred tax liabilities: (89,229) (97,137) Net deferred tax liabilities $ (7,132) $ (5,531) Reported on the consolidated balance sheet as (after valuation allowance and jurisdictional netting): Net deferred tax assets $ 1,384 $ 2,197 Net deferred tax liabilities (8,516) (7,728) Net deferred tax liabilities $ (7,132) $ (5,531)
Summary of Operating Loss Carryforwards	The following table presents NOL and tax credit carryforwards as of December 31, 2022, which can be used to reduce our income tax payable in future years (in thousands): Region Gross Amount Tax Benefit Amount Amount with Expiration Carryforward Period Europe NOL $ 429,156 $ 104,075 $ 104,075 $ — Unlimited U.S. Federal NOL 112,259 23,574 8,474 15,100 2023 - 2038 U.S. State NOL 180,411 11,076 2,349 8,727 2023 - 2042 S. America & other regions NOL 11,183 3,664 3,410 254 2029 - 2038 Far East NOL 426 79 27 52 2025 - 2032 U.S. foreign tax credits — 15,850 — 15,850 2025 - 2030 U.S. R&D tax credits — 17,690 — 17,690 2023 - 2042 U.S. State research & development tax credits — 7,108 1,280 5,828 2030 - 2042 Other non-U.S. tax credits — 1,271 275 996 2023 - 2034 $ 733,435 $ 184,387 $ 119,890 $ 64,497
Schedule of Unrecognized Tax Benefits Roll Forward	The following table presents a reconciliation of our total gross unrecognized tax benefit for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Balance at beginning of year $ 1,741 $ 3,433 $ 15,995 Decreases: Tax positions related to prior years for settlement with tax authorities — (1,434) (13,989) Impact of foreign currency exchange rates (101) (258) 1,427 Balance at end of year $ 1,640 $ 1,741 $ 3,433
Schedule of Income Tax Examinations by Jurisdiction	The major jurisdictions where we are subject to income tax examinations are as follows: Jurisdiction Earliest Year Open U.S. - federal and state 2015 Italy 2016 Germany 2019 England and Wales 2018 Canada 2018

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table presents the basic and diluted weighted-average shares outstanding used in the computation of basic and diluted net income per share for the years ended December 31, 2022, 2021 and 2020 (in thousands of shares): 2022 2021 2020 Basic and diluted weighted average shares outstanding (1) 53,472 50,633 48,592 (1) Excluded from the computation of diluted earnings per share for the years ended December 31, 2022, 2021 and 2020 were stock options, SARs and RSUs t otaling 3.9 million, 3.9 million and 4.1 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)	12 Months Ended
	Dec. 31, 2022
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	We operate under three geographic regions: U.S., Europe, and Rest of World. The following table presents net revenue by operating segment and geographic region for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary United States $ 159,489 $ 154,073 $ 132,543 Europe (1) 127,064 134,562 122,062 Rest of World 213,761 194,344 192,127 500,314 482,979 446,732 Neuromodulation United States 374,542 358,476 282,509 Europe (1) 50,291 51,435 39,019 Rest of World 52,160 46,261 32,916 476,993 456,172 354,444 Advanced Circulatory Support United States 37,527 53,821 41,094 Europe (1) 1,447 1,120 1,027 Rest of World 327 518 200 39,301 55,459 42,321 Other (2) United States — 4,929 12,488 Europe (1) — 14,407 31,259 Rest of World 5,197 21,419 46,997 5,197 40,755 90,744 Totals United States 571,558 571,299 468,634 Europe (1) 178,802 201,524 193,367 Rest of World 271,445 262,542 272,240 Total net revenue (3) (4) $ 1,021,805 $ 1,035,365 $ 934,241 (1) Includes countries in Europe where we have a direct sales presence. Countries where sales are made through distributors are included in “Rest of World.” (2) For the years ended December 31, 2021 and 2020, other primarily includes the net revenue of the Company’s Heart Valve business, which was divested on June 1, 2021. (3) Net revenue to external customers includes $32.3 million, $35.8 million and $29.7 million in the United Kingdom, our country of domicile, for the years ended December 31, 2022, 2021 and 2020, respectively. (4) No single customer represented over 10% of our consolidated net revenue. No country’s net revenue exceeded 10% of our consolidated sales, except for the U.S. The following table presents a reconciliation of segment (loss) income from continuing operations to consolidated loss from continuing operations before tax for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary (1) $ 11,247 $ (6,429) $ 35,735 Neuromodulation 172,775 169,499 109,273 Advanced Circulatory Support (2) (142,590) 2,195 (575) Other (3) (4) (85,249) (129,082) (365,116) Total reportable segment (loss) income from continuing operations (43,817) 36,183 (220,683) Other expenses (5) 32,935 36,967 53,216 Operating loss from continuing operations (76,752) (784) (273,899) Interest expense (48,250) (50,151) (40,837) Loss on debt extinguishment — (60,238) (1,407) Foreign exchange and other income/(expense) 49,860 (13,299) (31,879) Loss from continuing operations before tax $ (75,142) $ (124,472) $ (348,022) (1) Results for the years ended December 31, 2022, 2021 and 2020 include a Litigation provision, net of $21.7 million, $38.1 million and $3.9 million, respectively. Refer to “Note 14. Commitments and Contingencies” for additional information. (2) Results for the year ended December 31, 2022 include a goodwill impairment of $129.4 million. Refer to “Note 8. Goodwill and Intangible Assets” for additional information. (3) Other includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. For the years ended December 31, 2021 and 2020, Other also includes the results of our Heart Valve business, which was divested on June 1, 2021. (4) Results for the year ended December 31, 2020 include $180.2 million and $21.3 million in impairments of the Heart Valves disposal group and allocated goodwill, respectively. Additionally, the results for the year ended December 31, 2020 include a $42.2 million decommissioning provision at our Saluggia site. Refer to “Note 5. Divestiture of Heart Valve Business” and “Note 14. Commitments and Contingencies”, respectively, for additional information. (5) Other expenses consists of merger and integration expense, restructuring expense and amortization of intangible assets. The following table presents assets by reportable segment as of December 31, 2022 and 2021 (in thousands): 2022 2021 Cardiopulmonary $ 874,143 $ 921,481 Neuromodulation 646,633 646,394 Advanced Circulatory Support 121,454 231,846 Other 652,543 401,230 Total assets $ 2,294,773 $ 2,200,951 The following table presents capital expenditures by segment for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Cardiopulmonary $ 13,828 $ 14,824 $ 20,975 Neuromodulation 369 179 7,318 Advanced Circulatory Support 1,773 1,326 733 Other (1) 10,622 5,984 6,890 Total capital expenditures $ 26,592 $ 22,313 $ 35,916 (1) Other includes corporate capital expenditures. For the years ended December 31, 2021 and 2020, Other also includes capital expenditures of our Heart Valve business, which was divested on June 1, 2021.
Long-lived Assets by Geographic Areas	The following table presents property, plant and equipment, net by geographic region as of December 31, 2022 and 2021 (in thousands): 2022 2021 United States $ 63,458 $ 60,852 Europe 79,654 85,313 Rest of World 4,075 3,901 Total property, plant and equipment, net $ 147,187 $ 150,066

Supplemental Financial Inform_2

Supplemental Financial Information (Tables)	12 Months Ended
	Dec. 31, 2022
Receivables [Abstract]
Schedule of Inventories	The following table presents the components of inventories as of December 31, 2022 and 2021 (in thousands): 2022 2021 Raw materials $ 70,027 $ 43,958 Work-in-process 15,508 14,161 Finished goods 43,844 47,721 Total inventories $ 129,379 $ 105,840
Schedule of Property, Plant and Equipment	The following table presents the components of property, plant and equipment, net as of December 31, 2022 and 2021 (in thousands): 2022 2021 Lives in Years Land $ 14,637 $ 15,099 Building and building improvements 80,611 79,475 5 to 36 Equipment, software, furniture and fixtures 206,892 195,919 2 to 10 Other 8,861 9,246 5 to 7 Capital investment in process 11,307 12,112 Total gross property, plant and equipment 322,308 311,851 Accumulated depreciation (175,121) (161,785) Total Property, plant and equipment, net $ 147,187 $ 150,066
Schedule of Accrued Liabilities	The following table presents the components of accrued liabilities and other as of December 31, 2022 and 2021 (in thousands): 2022 2021 Contract liabilities $ 10,226 $ 8,419 Operating lease liabilities (1) 9,379 11,261 Legal and other administrative costs 8,653 11,832 Research and development costs 7,020 5,329 Italian medical device payback law 6,414 5,533 Royalty accrual 3,950 3,611 Restructuring liabilities (2) 2,045 836 Provisions for agents, returns and other 1,678 2,535 Contingent consideration (3) — 11,552 Amount payable to Gyrus Capital S.A. — 11,418 Other accrued expenses 26,230 16,611 Total accrued liabilities and other $ 75,595 $ 88,937 (1) Refer to “Note 13. Leases.” (2) Refer to “Note 6. Restructuring.” (3) Refer to “Note 10. Fair Value Measurements.”
Schedule of Foreign Exchange and Other Gains/(Losses)	The following table presents the items included within foreign exchange and other income/(expense) on the consolidated statements of income (loss) for the years ended December 31, 2022, 2021 and 2020 (in thousands): 2022 2021 2020 Notes fair value adjustment (1) $ 96,025 $ (59,944) $ (46,805) Capped call fair value adjustment (1) (52,236) 34,327 29,206 Interest income 4,697 435 131 Foreign exchange rate fluctuations 378 (1,243) (4,851) Dividend income (2) 305 3,415 — Investment revaluation (2) — 4,642 — Other derivative liabilities fair value adjustment (1) — 4,290 (4,290) Notes issuance costs — — (2,482) Other 691 779 (2,788) Total foreign exchange and other income/(expense) $ 49,860 $ (13,299) $ (31,879) (1) Refer to “Note 10. Fair Value Measurements.” (2) Refer to “Note 9. Investments.”
Restrictions on Cash and Cash Equivalents	The following table presents a reconciliation of cash, cash equivalents and restricted cash reported on the consolidated balance sheets that sum to the total of the amounts shown on the consolidated statement of cash flows as of December 31, 2022 and 2021 (in thousands): 2022 2021 Cash and cash equivalents $ 214,172 $ 207,992 Restricted cash (1) 301,446 — Cash, cash equivalents and restricted cash $ 515,618 $ 207,992 (1) Restricted cash represents funds held as collateral for the SNIA Litigation Guarantee. Refer to “Note 14. Commitments and Contingencies.”
Schedule of Cash and Cash Equivalents	The following table presents a reconciliation of cash, cash equivalents and restricted cash reported on the consolidated balance sheets that sum to the total of the amounts shown on the consolidated statement of cash flows as of December 31, 2022 and 2021 (in thousands): 2022 2021 Cash and cash equivalents $ 214,172 $ 207,992 Restricted cash (1) 301,446 — Cash, cash equivalents and restricted cash $ 515,618 $ 207,992 (1) Restricted cash represents funds held as collateral for the SNIA Litigation Guarantee. Refer to “Note 14. Commitments and Contingencies.”

Nature of Operations - Narrativ

Nature of Operations - Narrative (Details)	12 Months Ended
	Dec. 31, 2022 segment
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Number of principal business franchises	3
RUSSIAN FEDERATION | Revenue Benchmark | Geographic Concentration Risk
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Concentration risk	1%

Basis of Presentation, Use of_3

Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies - Narrative (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Mar. 18, 2022	Dec. 31, 2021
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Restricted cash	$ 301,446		$ 0
Bridge Loan
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Restricted cash	$ 301,400
SNIA | Judicial Ruling | Bridge Loan
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Percentage of cash collateral required as guarantee	105%	105%

Revenue Recognition (Details)

Revenue Recognition (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Revenue Recognition and Deferred Revenue [Abstract]
Contract liabilities	$ 14.1	$ 9.8

Business Combinations - Narrati

Business Combinations - Narrative (Details) - USD ($) $ in Thousands		12 Months Ended
	May 02, 2022	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Cash to be paid at closing		$ 15,586
ALung
Business Acquisition [Line Items]
Percentage of voting interests acquired (percent)	97%
Maximum consideration	$ 110,000
Cash to be paid at closing	10,000
Contingent consideration	100,000
Noncash consideration	$ 5,500
Acquisition related costs		$ 5,100
ALung | ALung
Business Acquisition [Line Items]
Ownership percentage			3%

Business Combinations - Fair Va

Business Combinations - Fair Value of Consideration Transferred (Details) - USD ($) $ in Thousands		12 Months Ended
	May 02, 2022	Dec. 31, 2022
Business Acquisition [Line Items]
Cash and other considerations		$ 15,586
Contingent consideration		16,791
Fair value of consideration transferred		32,377
Measurement Period Adjustments
Business Acquisition [Line Items]
Cash and other considerations		0
Contingent consideration		(9,578)
Fair value of consideration transferred		(9,578)
ALung
Business Acquisition [Line Items]
Cash and other considerations	$ 10,000
ALung | Initial Fair Value of Consideration
Business Acquisition [Line Items]
Cash and other considerations		15,586
Contingent consideration		26,369
Fair value of consideration transferred		$ 41,955

Business Combinations - Purchas

Business Combinations - Purchase Price Allocation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill	$ 768,787	$ 899,525	$ 922,318	$ 915,794
ALung
Business Acquisition [Line Items]
Developed technology - 15-year life	2,900
Goodwill	26,870
Other assets and liabilities, net	2,607
Net assets acquired	$ 32,377
Useful life	15 years
ALung | Initial Fair Value of Consideration
Business Acquisition [Line Items]
Developed technology - 15-year life	$ 13,950
Goodwill	25,893
Other assets and liabilities, net	2,112
Net assets acquired	41,955
ALung | Measurement Period Adjustments
Business Acquisition [Line Items]
Developed technology - 15-year life	(11,050)
Goodwill	977
Other assets and liabilities, net	495
Net assets acquired	$ (9,578)

Business Combinations - Sales-b

Business Combinations - Sales-based Earnout (Details) $ in Thousands	Dec. 31, 2022 USD ($)	May 02, 2022 USD ($)	Dec. 31, 2021 USD ($)
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value at May 2, 2022	$ 85,292		$ 86,830
Level 3 | ALung
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value at May 2, 2022		$ 16,791
Risk-adjusted discount rate | Level 3 | Minimum | ALung
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Input		0.070
Risk-adjusted discount rate | Level 3 | Maximum | ALung
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Input		0.084
Credit risk discount rate | Level 3 | Minimum | ALung
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Input		0.064
Credit risk discount rate | Level 3 | Maximum | ALung
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Input		0.080
Revenue volatility | Level 3 | ALung
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Input		0.257

Divestiture of Heart Valve Bu_2

Divestiture of Heart Valve Business - Narrative (Details) - USD ($) $ in Thousands			3 Months Ended	12 Months Ended			87 Months Ended
	Apr. 09, 2021	Dec. 02, 2020	Dec. 31, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment of disposal group and loss on sale				$ 0	$ 0	$ 180,160
Impairment of goodwill		$ 21,300		129,396	0	$ 21,269	$ 193,100
Heart Valves
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Payment for working capital and indebtedness adjustments				4,800			$ 4,800
Loss on sale					(1,900)
Services income					1,900
Heart Valves | Discontinued Operations, Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration		$ 64,100
Sale and purchase deferral period	2 years
Impairment of disposal group and loss on sale			$ 180,200
Impairment of goodwill			$ 21,300
Heart Valves | Business Combination, Consideration, Tranche One | Discontinued Operations, Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sales of business, affiliate and productive assets					$ 45,500
Heart Valves | Business Combination, Consideration, Tranche Two | Discontinued Operations, Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sales of business, affiliate and productive assets				$ 9,500

Restructuring - Narrative (Deta

Restructuring - Narrative (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($) employee	Dec. 31, 2020 USD ($) employee	Dec. 31, 2019 USD ($)
Restructuring Cost and Reserve [Line Items]
Charges	$ 6,600
Restructuring Reserve	2,045	$ 836	$ 6,295	$ 5,497
Cash payments	(5,402)	(15,172)	(6,773)
Restructuring and Related Cost, Expected Cost Remaining	10,000
Continuing And Discontinued Operations
Restructuring Cost and Reserve [Line Items]
Charges	6,611	9,713	7,571
Employee Severance and Other Termination Costs
Restructuring Cost and Reserve [Line Items]
Charges	6,611	7,963	7,571
Restructuring Reserve	2,045	836	5,749	4,097
Cash payments	(5,402)	(12,876)	(5,919)
Other
Restructuring Cost and Reserve [Line Items]
Charges	0	1,750	0
Restructuring Reserve	0	0	546	$ 1,400
Cash payments	$ 0	(2,296)	(854)
2020 Restructuring Plan
Restructuring Cost and Reserve [Line Items]
Charges		$ 9,700	$ 5,300
Restructuring and related cost, severance costs, number of employees | employee		27	54

Restructuring - Reconciliation

Restructuring - Reconciliation of Accruals and Other Reserves Related to Restructuring (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Restructuring Reserve [Roll Forward]
Beginning liability balance	$ 836	$ 6,295	$ 5,497
Charges	6,600
Cash payments	(5,402)	(15,172)	(6,773)
Ending liability balance	2,045	836	6,295
Restructuring charges incurred to date	135,400
Employee Severance and Other Termination Costs
Restructuring Reserve [Roll Forward]
Beginning liability balance	836	5,749	4,097
Charges	6,611	7,963	7,571
Cash payments	(5,402)	(12,876)	(5,919)
Ending liability balance	2,045	836	5,749
Other
Restructuring Reserve [Roll Forward]
Beginning liability balance	0	546	1,400
Charges	0	1,750	0
Cash payments	0	(2,296)	(854)
Ending liability balance	0	0	546
Continuing And Discontinued Operations
Restructuring Reserve [Roll Forward]
Charges	$ 6,611	$ 9,713	$ 7,571

Restructuring - Restructuring E

Restructuring - Restructuring Expense by Reportable Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Restructuring Cost and Reserve [Line Items]
Charges	$ 6,600
Operating Segments | Cardiopulmonary
Restructuring Cost and Reserve [Line Items]
Charges	697	$ 2,844	$ 1,040
Operating Segments | Neuromodulation
Restructuring Cost and Reserve [Line Items]
Charges	2,651	1,531	3,223
Operating Segments | Advanced Circulatory Support
Restructuring Cost and Reserve [Line Items]
Charges	1,999	0	0
Other
Restructuring Cost and Reserve [Line Items]
Charges	1,264	5,338	3,308
Continuing And Discontinued Operations
Restructuring Cost and Reserve [Line Items]
Charges	$ 6,611	$ 9,713	$ 7,571

Product Remediation Liability -

Product Remediation Liability - Changes in Product Remediation Liability (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Loss Contingency Accrual [Roll Forward]
Balance at beginning of period	$ 807	$ 1,056	$ 3,251
Adjustments		712	3,199
Remediation activity	(15)	(880)	(5,743)
Effect of changes in foreign currency exchange rates	(47)	(81)	349
Balance at end of period	$ 745	$ 807	$ 1,056

Product Remediation Liability_2

Product Remediation Liability - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Product Liability
Loss Contingencies [Line Items]
Loss contingency accrual	$ 32,487	$ 39,470	$ 36,490	$ 170,404
As Revised
Loss Contingencies [Line Items]
Product remediation expense	$ 0	$ 800	$ 7,900

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Finite-Lived and Indefinite-Lived Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Finite-lived intangible assets:
Finite-lived intangible assets, gross	$ 426,726	$ 438,276
Accumulated amortization	170,173	150,600
Net finite-lived intangible assets	256,553	287,676
Indefinite-lived intangible assets:
Goodwill	768,787	899,525	$ 922,318	$ 915,794
Total indefinite-lived intangible assets	880,793	1,011,531
In-process research and development
Indefinite-lived intangible assets:
IPR&D	112,006	112,006
Customer relationships
Finite-lived intangible assets:
Finite-lived intangible assets, gross	184,397	192,800
Accumulated amortization	72,820	65,106
Developed technology
Finite-lived intangible assets:
Finite-lived intangible assets, gross	217,205	219,706
Accumulated amortization	80,219	68,488
Trade names
Finite-lived intangible assets:
Finite-lived intangible assets, gross	24,368	25,154
Accumulated amortization	16,483	16,500
Other intangible assets
Finite-lived intangible assets:
Finite-lived intangible assets, gross	756	616
Accumulated amortization	$ 651	$ 506

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Amortization Periods for Finite-lived Intangible Assets (Details)	12 Months Ended
	Dec. 31, 2022
Customer relationships | Minimum
Finite-lived intangible assets:
Useful life	8 years
Customer relationships | Maximum
Finite-lived intangible assets:
Useful life	18 years
Developed technology | Minimum
Finite-lived intangible assets:
Useful life	14 years
Developed technology | Maximum
Finite-lived intangible assets:
Useful life	17 years
Trade names | Minimum
Finite-lived intangible assets:
Useful life	15 years
Trade names | Maximum
Finite-lived intangible assets:
Useful life	15 years

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Estimated Future Amortization Expense (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
2023	$ 25,372
2024	25,372
2025	25,372
2026	25,372
2027	24,957
Thereafter	130,108
Net finite-lived intangible assets	$ 256,553	$ 287,676

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Goodwill Carrying Amounts (Details) - USD ($) $ in Thousands		12 Months Ended			87 Months Ended
	Dec. 02, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2022
Goodwill [Roll Forward]
Goodwill, starting balance		$ 899,525	$ 922,318	$ 915,794
Goodwill as a result of acquisition		25,893
Measurement period adjustments		977
Impairment	$ (21,300)	(129,396)	0	(21,269)	$ (193,100)
Foreign currency adjustments		(28,212)	(22,793)	27,793
Goodwill, ending balance		768,787	899,525	922,318	768,787
Heart Valves
Goodwill [Roll Forward]
Impairment				(21,300)
Advanced Circulatory Support
Goodwill [Roll Forward]
Impairment		(129,400)
Operating Segments | Cardiopulmonary
Goodwill [Roll Forward]
Goodwill, starting balance		398,245	421,038	394,735
Goodwill as a result of acquisition		0
Measurement period adjustments		0
Impairment		0		0
Foreign currency adjustments		(28,212)	(22,793)	26,303
Goodwill, ending balance		370,033	398,245	421,038	370,033
Operating Segments | Neuromodulation
Goodwill [Roll Forward]
Goodwill, starting balance		398,754	398,754	398,754
Goodwill as a result of acquisition		0
Measurement period adjustments		0
Impairment		0		0
Foreign currency adjustments		0	0	0
Goodwill, ending balance		398,754	398,754	398,754	398,754
Operating Segments | Advanced Circulatory Support
Goodwill [Roll Forward]
Goodwill, starting balance		102,526	102,526	102,526
Goodwill as a result of acquisition		25,893
Measurement period adjustments		977
Impairment		(129,396)		0
Foreign currency adjustments		0	0	0
Goodwill, ending balance		0	102,526	102,526	0
Other
Goodwill [Roll Forward]
Goodwill, starting balance		0	0	19,779
Goodwill as a result of acquisition		0
Measurement period adjustments		0
Impairment		0		(21,269)
Foreign currency adjustments		0	0	1,490
Goodwill, ending balance		$ 0	$ 0	$ 0	$ 0

Goodwill and Intangible Asset_6

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Thousands		9 Months Ended	12 Months Ended			87 Months Ended
	Dec. 02, 2020	Sep. 30, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2022	Dec. 31, 2019
Indefinite-lived intangible assets:
Goodwill			$ 768,787	$ 899,525	$ 922,318	$ 768,787	$ 915,794
Impairment of goodwill	$ 21,300		$ 129,396	$ 0	$ 21,269	$ 193,100
Percent decrease in sales		29%
Cardiopulmonary
Indefinite-lived intangible assets:
Goodwill	$ 21,300
Percentage of fair value in excess of carrying amount			32%			32%
Neuromodulation
Indefinite-lived intangible assets:
Percentage of fair value in excess of carrying amount			467%			467%

Investments - Schedule of Long-

Investments - Schedule of Long-term Investments (Details) $ in Thousands, € in Millions	3 Months Ended
	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2022 EUR (€)	Dec. 31, 2021 USD ($)
Schedule of Investments [Line Items]
Carrying value		$ 14,288		$ 15,811
Equity method investments		1,978		787
Total investments		16,266		16,598
Equity method investments, required funding		3,200	€ 3
ALung
Schedule of Investments [Line Items]
Carrying value				$ 3,000
ALung | ALung
Schedule of Investments [Line Items]
Ownership percentage				3%
ShiraTronics, Inc.
Schedule of Investments [Line Items]
Carrying value		5,000		$ 3,331
Noctrix Health, Inc.
Schedule of Investments [Line Items]
Carrying value		3,159		3,159
Ceribell, Inc.
Schedule of Investments [Line Items]
Carrying value		3,000		3,000
MD Start II
Schedule of Investments [Line Items]
Carrying value		1,069		1,135
Proceeds from cash dividend received	$ 3,100
Rainbow Medical Ltd.
Schedule of Investments [Line Items]
Carrying value		1,047		1,111
Highlife S.A.S.
Schedule of Investments [Line Items]
Carrying value		1,013		1,075
A Lung Technologies Inc
Schedule of Investments [Line Items]
Carrying value		$ 0		3,000
A Lung Technologies Inc | Convertible Notes Receivable
Schedule of Investments [Line Items]
Notes receivable gross				$ 2,500

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Assets and Liabilities Measured on a Recurring Basis (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Liabilities
Contingent consideration	$ 85,292	$ 86,830
Derivative Liability, Statement Of Financial Position, Extensible Enumeration, Not Disclosed Flag	Contingent consideration arrangements
Recurring
Assets
Convertible notes receivable	$ 285	2,767
Total assets	56,011	109,700
Liabilities
Contingent consideration	85,292	98,382
Total liabilities	176,853	281,795
Recurring | Embedded Derivative Financial Instruments
Liabilities
Derivative liability	85,675	181,700
Recurring | Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		243
Liabilities
Derivative liability		1,286
Recurring | Designated as Hedging Instrument | Interest Rate Swap Contracts
Assets
Derivative asset	1,333
Recurring | Not Designated as Hedging Instrument
Assets
Derivative asset	54,393	106,629
Recurring | Not Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		61
Recurring | Not Designated as Hedging Instrument | Freestanding Instrument
Liabilities
Derivative liability	5,886	427
Recurring | Level 1
Assets
Convertible notes receivable	0	0
Total assets	0	0
Liabilities
Contingent consideration	0	0
Total liabilities	0	0
Recurring | Level 1 | Embedded Derivative Financial Instruments
Liabilities
Derivative liability	0	0
Recurring | Level 1 | Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		0
Liabilities
Derivative liability		0
Recurring | Level 1 | Designated as Hedging Instrument | Interest Rate Swap Contracts
Assets
Derivative asset	0
Recurring | Level 1 | Not Designated as Hedging Instrument
Assets
Derivative asset	0	0
Recurring | Level 1 | Not Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		0
Recurring | Level 1 | Not Designated as Hedging Instrument | Freestanding Instrument
Liabilities
Derivative liability	0	0
Recurring | Level 2
Assets
Convertible notes receivable	0	0
Total assets	1,333	304
Liabilities
Contingent consideration	0	0
Total liabilities	5,886	1,713
Recurring | Level 2 | Embedded Derivative Financial Instruments
Liabilities
Derivative liability	0	0
Recurring | Level 2 | Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		243
Liabilities
Derivative liability		1,286
Recurring | Level 2 | Designated as Hedging Instrument | Interest Rate Swap Contracts
Assets
Derivative asset	1,333
Recurring | Level 2 | Not Designated as Hedging Instrument
Assets
Derivative asset	0	0
Recurring | Level 2 | Not Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		61
Recurring | Level 2 | Not Designated as Hedging Instrument | Freestanding Instrument
Liabilities
Derivative liability	5,886	427
Recurring | Level 3
Assets
Convertible notes receivable	285	2,767
Total assets	54,678	109,396
Liabilities
Derivative liability	85,292
Contingent consideration		98,382
Total liabilities	170,967	280,082
Recurring | Level 3 | Embedded Derivative Financial Instruments
Liabilities
Derivative liability	85,675	181,700
Recurring | Level 3 | Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		0
Liabilities
Derivative liability		0
Recurring | Level 3 | Designated as Hedging Instrument | Interest Rate Swap Contracts
Assets
Derivative asset	0
Recurring | Level 3 | Not Designated as Hedging Instrument
Assets
Derivative asset	54,393	106,629
Recurring | Level 3 | Not Designated as Hedging Instrument | Foreign Exchange Contract
Assets
Derivative asset		0
Recurring | Level 3 | Not Designated as Hedging Instrument | Freestanding Instrument
Liabilities
Derivative liability	$ 0	$ 0

Fair Value Measurements - Recur

Fair Value Measurements - Recurring Fair Value Measurements Using Significant Unobservable Inputs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Liabilities Measured on Recurring Basis
Contingent consideration paid		$ 6,000
Cost of goods sold
Liabilities Measured on Recurring Basis
Changes in fair value	$ 10,500	$ 8,500
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Cost of Goods and Services Sold	Cost of Goods and Services Sold
Research and development
Liabilities Measured on Recurring Basis
Changes in fair value	$ 19,400	$ (9,100)
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Research and development	Research and development
Level 3 | Recurring
Liabilities Measured on Recurring Basis
Contingent consideration, beginning	$ 98,382
Contingent consideration, ending	85,292	$ 98,382
Level 3 | Recurring | Embedded Exchange Feature Derivative Liability
Liabilities Measured on Recurring Basis
Contingent consideration, beginning	181,700	121,756
Payments	0	0
Additions	0
Measurement period adjustments	0
Changes in fair value	96,025	(59,944)
Contingent consideration, ending	85,675	181,700
Level 3 | Recurring | Other Derivative Liabilities
Liabilities Measured on Recurring Basis
Contingent consideration, beginning	0	4,290
Payments	0	0
Additions	0
Measurement period adjustments	0
Changes in fair value	0	4,290
Contingent consideration, ending	0	0
Level 3 | Recurring | Contingent Consideration Liability Arrangements
Liabilities Measured on Recurring Basis
Contingent consideration, beginning	98,382	103,818
Payments	0	(6,000)
Additions	26,369
Measurement period adjustments	(9,578)
Changes in fair value	29,881	(564)
Contingent consideration, ending	85,292	98,382
Level 3 | Recurring | Capped Call Derivative Asset
Assets Measured on Recurring Basis
As of beginning period	106,629	72,302
Additions	0
Measurement period adjustments	0
Payments	0	0
Changes in fair value	(52,236)	34,327
Total at period end	54,393	106,629
Level 3 | Recurring | Convertible Notes Receivable
Assets Measured on Recurring Basis
As of beginning period	2,767	2,775
Additions	0
Measurement period adjustments	0
Payments	(2,495)	0
Changes in fair value	13	(8)
Total at period end	$ 285	$ 2,767

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Jun. 17, 2020 USD ($)
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Total long-term facilities	$ 538,959,000	$ 236,795,000
Embedded Derivative Financial Instruments
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
10 percent decrease in stock price volatility, fair value	70,600,000
10 percent increase in stock price volatility, fair value	$ 100,300,000
Embedded Derivative Financial Instruments | Measurement Input, Stock Price Volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability, measurement input	0.43
Capped Call
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
10 percent decrease in stock price volatility, fair value	$ 52,100,000
10 percent increase in stock price volatility, fair value	53,700,000
Senior Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount			$ 287,500,000
Total long-term facilities	239,568,000	225,140,000
2020 Cash Exchangeable Senior Notes | Senior Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount			$ 287,500,000
Debt instrument, fair value	$ 328,100,000	$ 465,700,000

Fair Value Measurements - Fai_2

Fair Value Measurements - Fair Value of Contingent Consideration by Acquisition (Details) - USD ($) $ in Thousands	Dec. 31, 2022	May 02, 2022	Dec. 31, 2021
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 85,292		$ 86,830
Recurring
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	85,292		98,382
Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration			98,382
Total fair value of Level 3 contingent consideration arrangements	85,292		98,382
ImThera | Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	69,389		86,830
ALung | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration		$ 16,791
ALung | Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	15,903		0
TandemLife | Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 0		$ 11,552

Fair Value Measurements - Signi

Fair Value Measurements - Significant Unobservable Inputs Related to Contingent Consideration (Details) - Level 3	Dec. 31, 2022
ImThera | Discount rate | Discounted cash flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.105
ImThera | Probability of payment | Discounted cash flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
ImThera | Probability of payment | Monte Carlo simulation | Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
ImThera | Revenue volatility | Monte Carlo simulation
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.325
ImThera | Risk-adjusted discount rate | Monte Carlo simulation | Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.143
ImThera | Risk-adjusted discount rate | Monte Carlo simulation | Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.146
ImThera | Credit risk discount rate | Monte Carlo simulation | Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.108
ImThera | Credit risk discount rate | Monte Carlo simulation | Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.114
ALung | Revenue volatility | Monte Carlo simulation
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.289
ALung | Risk-adjusted discount rate | Monte Carlo simulation | Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.097
ALung | Risk-adjusted discount rate | Monte Carlo simulation | Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.103
ALung | Credit risk discount rate | Monte Carlo simulation | Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.100
ALung | Credit risk discount rate | Monte Carlo simulation | Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.111

Financing Arrangements - Long-T

Financing Arrangements - Long-Term Debt Outstanding (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Jun. 17, 2020
Debt Instrument [Line Items]
Total long-term facilities	$ 538,959	$ 236,795
Less current portion of long-term debt	20,892	226,946
Total long-term debt obligations	518,067	9,849
Senior Notes
Debt Instrument [Line Items]
Total long-term facilities	$ 239,568	225,140
Interest rate, stated percentage	3%		3%
Other Debt Obligations
Debt Instrument [Line Items]
Total long-term facilities	$ 534	663
Term Loan
Debt Instrument [Line Items]
Total long-term facilities	$ 289,294	0
Interest rate, stated percentage	7.21%
Bank of America Merrill Lynch Banco Múltiplo S.A.
Debt Instrument [Line Items]
Interest rate, stated percentage	16.20%
Bank of America Merrill Lynch Banco Múltiplo S.A. | Loans Payable
Debt Instrument [Line Items]
Total long-term facilities	$ 6,462	6,113
Mediocredito Italiano | Minimum
Debt Instrument [Line Items]
Interest rate, stated percentage	0.50%
Mediocredito Italiano | Maximum
Debt Instrument [Line Items]
Interest rate, stated percentage	3.47%
Mediocredito Italiano | Loans Payable
Debt Instrument [Line Items]
Total long-term facilities	$ 1,601	3,379
Bank of America, U.S.
Debt Instrument [Line Items]
Interest rate, stated percentage	5.45%
Bank of America, U.S. | Loans Payable
Debt Instrument [Line Items]
Total long-term facilities	$ 1,500	$ 1,500

Financing Arrangements - Maturi

Financing Arrangements - Maturities of Long-Term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
2023	$ 20,914
2024	15,092
2025	306,301
2026	26,310
2027	226,875
Thereafter	252
Total long-term facilities	595,744
Less: Debt issuance costs	(56,785)
Total long-term facilities	$ 538,959	$ 236,795

Financing Arrangements - Narrat

Financing Arrangements - Narrative (Details) $ / shares in Units, € in Millions				12 Months Ended
	Jul. 06, 2022 USD ($)	Aug. 12, 2021 USD ($)	Jun. 17, 2020 USD ($)	Dec. 31, 2022 USD ($) claim $ / shares	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2022 £ / shares	Mar. 18, 2022	Mar. 16, 2022 USD ($)	Feb. 24, 2022 USD ($)	Feb. 24, 2022 EUR (€)	Aug. 13, 2021 USD ($)
Debt Instrument [Line Items]
Restricted cash				$ 301,446,000	$ 0
Amortization of debt issuance costs				21,334,000	16,657,000	$ 9,710,000
Proceeds from long-term debt obligations				507,547,000	0	886,899,000
Loss on debt extinguishment				0	60,238,000	1,407,000
Repayments of debt				528,000,000
Payment of make-whole premium on long-term debt obligations				$ 0	35,594,000	0
Capped Call
Debt Instrument [Line Items]
Derivative, cap price per share (in dollars per share) | $ / shares				$ 100
Derivative asset				$ 54,400,000	106,600,000
Bridge Loan
Debt Instrument [Line Items]
Restricted cash				$ 301,400,000
Bridge Loan | SNIA | Judicial Ruling
Debt Instrument [Line Items]
Percentage of cash collateral required as guarantee				105%				105%
Senior Notes
Debt Instrument [Line Items]
Effective interest rate (percent)				9.95%
Debt discounts and issuance costs			$ 82,000,000
Amortization of debt issuance costs				$ 14,400,000	13,100,000	$ 6,600,000
Unamortized discount (premium), net				$ 47,900,000	62,400,000
Debt instrument, face amount			287,500,000
Debt issuance costs, net			$ 7,000,000
Interest rate, stated percentage			3%	3%
Proceeds from long-term debt obligations			$ 278,000,000
Unamortized discount			$ 75,000,000
Redemption, threshold par value (in GBP per share) | £ / shares							£ 1
Redemption price, percentage of exchange price				130%
Conversion price (in dollars per share) | $ / shares				$ 79.27
Redemption, threshold trading days | claim				20
Redemption, threshold consecutive trading days | claim				30
Option to exchange, price per share (in dollars per share) | $ / shares				$ 60.98
Redemption price, percentage				100%
Fair value of embedded derivative liability				$ 85,700,000	181,700,000
Conversion ratio				0.016398
Secured Debt
Debt Instrument [Line Items]
Loss on debt extinguishment					(58,600,000)
Repayments of debt		$ 450,000,000
Payment of make-whole premium on long-term debt obligations		35,600,000
Write off of unamortized debt issuance costs		23,000,000
Revolving Credit Facility
Debt Instrument [Line Items]
Short-term debt				$ 2,500,000	$ 2,700,000
Line of credit facility, maximum borrowing capacity												$ 125,000,000
Commitment fee percentage				0.50%	0.25%
Loss on debt extinguishment				$ 1,600,000
Termination of credit facility, amount		$ 50,000,000
Revolving Credit Facility | Initial Term Facility
Debt Instrument [Line Items]
Effective interest rate (percent)				6.53%
Revolving Credit Facility | Goldman Sachs Bank USA
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity | €											€ 200
Revolving Credit Facility | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR floor rate												0%
Revolving Credit Facility | Bridge Loan
Debt Instrument [Line Items]
Debt discounts and issuance costs										$ 4,500,000
Amortization of debt issuance costs				$ 4,500,000
Revolving Credit Facility | Bridge Loan | Goldman Sachs Bank USA
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity									$ 220,000,000
Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Debt instrument, term	5 years
Line of credit facility, maximum borrowing capacity	$ 350,000,000
Debt discounts and issuance costs				9,600,000
Amortization of debt issuance costs				800,000
Unamortized discount (premium), net				10,700,000
Days to maturity	91 days
Discount rate	1.50%
Commitment fee percentage	0.50%
Amortization percentage, year one	1.90%
Amortization percentage, year two	5%
Amortization percentage, year three	5%
Amortization percentage, year four	7.50%
Amortization percentage, year five	10%
Revolving Credit Facility | Line of Credit | Initial Term Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 300,000,000
Revolving Credit Facility | Line of Credit | Delayed Draw Term Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 50,000,000
Line of credit, remaining borrowing capacity				50,000,000
Debt discounts and issuance costs				1,600,000
Amortization of debt issuance costs				1,100,000
Unamortized discount (premium), net				$ 500,000
Revolving Credit Facility | Line of Credit | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	3.50%
Revolving Credit Facility | Minimum
Debt Instrument [Line Items]
Effective interest rate (percent)				4.24%
Revolving Credit Facility | Maximum
Debt Instrument [Line Items]
Effective interest rate (percent)				16.35%
Debt instrument, term				365 days
Net leverage ratio, threshold for four consecutive fiscal quarters												3.50
Interest coverage ratio, threshold for four consecutive fiscal quarters												3

Derivatives and Risk Manageme_3

Derivatives and Risk Management - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Derivative [Line Items]
Derivatives, percentage of notional amount covering outstanding principal	70%
Foreign Exchange Contract
Derivative [Line Items]
Gain (loss) on derivative	$ 4.5	$ 10.9	$ (16.6)
Foreign Exchange Contract | Not Designated as Hedging Instrument
Derivative [Line Items]
Notional amount	$ 154.5	$ 136.7

Derivatives and Risk Manageme_4

Derivatives and Risk Management - Derivative Notional Amounts (Details) - Designated as Hedging Instrument - Cash Flow Hedging - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Derivative [Line Items]
Notional amount	$ 210,000	$ 76,032
Foreign Exchange Contract | British Pounds
Derivative [Line Items]
Notional amount	0	11,160
Foreign Exchange Contract | Japanese Yen
Derivative [Line Items]
Notional amount	0	6,648
Foreign Exchange Contract | Euros
Derivative [Line Items]
Notional amount	0	58,224
Interest Rate Swap Contracts
Derivative [Line Items]
Notional amount	$ 210,000	$ 0

Derivatives and Risk Manageme_5

Derivatives and Risk Management - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Interest Rate Swap Contracts | Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Line Items]
After-tax Net Gain in AOCI	$ 966
After-tax Net Gain Expected to be Reclassified to Earnings in Next 12 Months	966
Cash Flow Hedging
Derivative Instruments, Gain (Loss) [Line Items]
(Loss) Gain Recognized in OCI	(3,688)	$ (3,922)	$ 1,724
Loss Reclassified from AOCI to Earnings	(5,599)	75	(655)
Cash Flow Hedging | Foreign Exchange Contract | Foreign exchange and other income/(expense)
Derivative Instruments, Gain (Loss) [Line Items]
(Loss) Gain Recognized in OCI	(4,602)	(3,922)	1,724
Loss Reclassified from AOCI to Earnings	(382)	(2,333)	(1,522)
Cash Flow Hedging | Foreign Exchange Contract | Selling, general and administrative
Derivative Instruments, Gain (Loss) [Line Items]
(Loss) Gain Recognized in OCI	0	0	0
Loss Reclassified from AOCI to Earnings	(5,165)	$ 2,408	980
Cash Flow Hedging | Interest Rate Swap Contracts | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
(Loss) Gain Recognized in OCI			0
Loss Reclassified from AOCI to Earnings			$ (113)
Cash Flow Hedging | Interest Rate Swap Contracts | Interest expense | Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Line Items]
(Loss) Gain Recognized in OCI	914
Loss Reclassified from AOCI to Earnings	$ (52)

Derivatives and Risk Manageme_6

Derivatives and Risk Management - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Derivatives, Fair Value [Line Items]
Total asset derivatives	$ 55,726	$ 106,933
Total liability derivatives	91,561	183,413
Designated as Hedging Instrument
Derivatives, Fair Value [Line Items]
Total asset derivatives	1,333	243
Total liability derivatives		1,286
Designated as Hedging Instrument | Current derivative assets | Interest Rate Swap Contracts
Derivatives, Fair Value [Line Items]
Total asset derivatives	1,333
Designated as Hedging Instrument | Current derivative liabilities | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives		243
Total liability derivatives		1,286
Not Designated as Hedging Instrument
Derivatives, Fair Value [Line Items]
Total asset derivatives	54,393	106,690
Total liability derivatives	91,561	182,127
Not Designated as Hedging Instrument | Current derivative assets | Capped Call
Derivatives, Fair Value [Line Items]
Total asset derivatives		106,629
Not Designated as Hedging Instrument | Current derivative liabilities | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives		61
Total liability derivatives	5,886	427
Not Designated as Hedging Instrument | Current derivative liabilities | Embedded Derivative Financial Instruments
Derivatives, Fair Value [Line Items]
Total liability derivatives		$ 181,700
Not Designated as Hedging Instrument | Long-term derivative assets | Capped Call
Derivatives, Fair Value [Line Items]
Total asset derivatives	54,393
Not Designated as Hedging Instrument | Long-term derivative liabilities | Embedded Derivative Financial Instruments
Derivatives, Fair Value [Line Items]
Total liability derivatives	$ 85,675

Leases - Components of Operatin

Leases - Components of Operating Lease Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease, renewal term	12 years
Assets
Operating lease right-of-use assets	$ 35,830	$ 40,600
Liabilities
Accrued liabilities and other	9,379	11,261
Long-term operating lease liabilities	29,548	35,919
Total lease liabilities	$ 38,927	$ 47,180
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities and other	Accrued liabilities and other

Leases - Costs (Details)

Leases - Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Operating lease cost	$ 10,408	$ 18,070	$ 14,156
Variable lease cost	580	1,200	1,097
Short-term lease cost	468	1,084	415
Total lease cost	$ 11,456	$ 20,354	$ 15,668

Leases - Contractual Maturities

Leases - Contractual Maturities (Details) $ in Thousands	Dec. 31, 2022 USD ($)
Leases [Abstract]
2023	$ 10,520
2024	8,095
2025	5,372
2026	3,998
2027	3,570
Thereafter	12,747
Total lease payments	44,302
Less: Amount representing interest	5,375
Present value of lease liabilities	$ 38,927

Leases - Lease Term and Discoun

Leases - Lease Term and Discount Rate (Details)	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Weighted Average Remaining Lease Term	6 years 6 months	5 years 9 months 18 days
Weighted Average Discount Rate	3.90%	3.20%

Leases - Cash Flow (Details)

Leases - Cash Flow (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$ 12,468	$ 13,650	$ 14,601
Operating lease assets obtained in exchange for lease liabilities	$ 7,820	$ 9,037	$ 8,547

Commitments and Contingencies -

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

1 Months Ended

3 Months Ended

12 Months Ended

Feb. 27, 2023 claim

Jul. 29, 2022 USD ($)

Jul. 29, 2022 EUR (€)

Feb. 21, 2022 EUR (€)

Dec. 31, 2021 USD ($)

Mar. 29, 2019 USD ($)

Jan. 31, 2021 EUR (€) repository_site

Jan. 31, 2020 USD ($)

Dec. 31, 2020 USD ($)

Dec. 31, 2022 USD ($)

Dec. 31, 2021 USD ($)

Dec. 31, 2020 USD ($)

Dec. 31, 2016 EUR (€)

Apr. 30, 2022 EUR (€)

Feb. 24, 2022 EUR (€)

Nov. 30, 2021 EUR (€)

Aug. 13, 2021 USD ($)

Dec. 31, 2019 USD ($)

Mar. 05, 2019 EUR (€)

Other Commitments [Line Items]

Reimbursed legal fees

$ 312

€ 292

Annual environmental maintenance | €

€ 1,000

Heart Valves

Other Commitments [Line Items]

Standard product warranty, cap on claims

$ 8,000

Revolving Credit Facility

Other Commitments [Line Items]

Line of credit facility, maximum borrowing capacity

$ 125,000

Revolving Credit Facility | Goldman Sachs Bank USA

Other Commitments [Line Items]

Line of credit facility, maximum borrowing capacity | €

€ 200,000

Saluggia, Italy

Other Commitments [Line Items]

Number of national repository sites | repository_site

67

Loss contingency accrual provision

$ 42,200

Estimate of possible loss

39,300

$ 36,600

$ 39,300

Saluggia, Italy | Minimum

Other Commitments [Line Items]

Estimated litigation provision

36,600

Saluggia, Italy | Maximum

Other Commitments [Line Items]

Estimated litigation provision

46,600

Subsequent Event

Other Commitments [Line Items]

Number of claims | claim

85

Number of claims settled but not yet dismissed | claim

2

Pending Litigation

Other Commitments [Line Items]

Estimate of possible loss

611,600

€ 572,100

Product Liability

Other Commitments [Line Items]

Loss contingency accrual provision

22,300

38,100

$ 3,900

Litigation settlement, amount awarded to other party

$ 225,000

Loss contingency accrual

$ 39,470

$ 36,490

32,487

39,470

36,490

$ 170,404

Bond required to be posted

28,867

$ 34,808

$ 138,178

Product Liability | Second Payment

Other Commitments [Line Items]

Payments for legal settlements

$ 90,000

SNIA | Judicial Ruling

Other Commitments [Line Items]

Estimate of possible loss

484,900

€ 453,600

SNIA | Judicial Ruling | Surety Bond

Other Commitments [Line Items]

Bond required to be posted

€ 270,000

288,600

SNIA | SNIA s.p.a | Pending Litigation

Other Commitments [Line Items]

Compensation sought

3,700,000

Non-privileged creditor, amount | €

€ 454,000

Mitral Demand Letter | Pending Litigation

Other Commitments [Line Items]

Compensation sought

$ 22,200

€ 20,800

Italian MedTech Payback | Pending Litigation

Other Commitments [Line Items]

Estimate of possible loss

$ 6,400

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Product Liability (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Loss Contingency Accrual [Roll Forward]
Less current portion of litigation provision liability	$ 29,481
Long-term portion of litigation provision liability	3,006
Product Liability
Loss Contingency Accrual [Roll Forward]
Beginning liability	39,470	$ 36,490	$ 170,404
Payments	(28,867)	(34,808)	(138,178)
Adjustments	22,309	38,068	3,906
FX and other	(425)	(280)	358
Ending liability	$ 32,487	$ 39,470	$ 36,490

Stockholders' Equity - Narrativ

Stockholders' Equity - Narrative (Details) $ / shares in Units, $ in Thousands		12 Months Ended
	Aug. 06, 2021 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2022 £ / shares shares	Dec. 31, 2021 £ / shares shares	Aug. 06, 2021 £ / shares shares	Aug. 06, 2021 $ / shares shares
Class of Stock [Line Items]
Ordinary shares issued (in shares) | shares					53,851,979	53,761,510	4,181,818	4,181,818
Ordinary shares, par value (in pounds per share) | £ / shares					£ 1	£ 1	£ 1
Offering price (in USD per share) | $ / shares								$ 82.50
Proceeds from issuance of ordinary shares, net	$ 322,600	$ 0	$ 322,557	$ 0
Repayment of long-term debt obligations		$ 223,541	$ 452,256	$ 482,065
Senior Loans
Class of Stock [Line Items]
Repayment of long-term debt obligations	$ 450,000

Stockholders' Equity - Changes

Stockholders' Equity - Changes in Accumulated Other Comprehensive Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	$ 1,294,645	$ 1,109,265	$ 1,377,964
Tax expense	0	719	(415)
Reclassification of loss from accumulated other comprehensive income (loss), after tax	(46,541)	(35,644)	47,119
Other comprehensive income before reclassifications, net of tax	(46,541)	(34,925)	46,704
Reclassification of loss from accumulated other comprehensive income (loss), before tax	5,599	(75)	655
Reclassification of tax benefit	0	14	(158)
Reclassification of loss from accumulated other comprehensive income (loss), after tax	5,599	(61)	497
Total other comprehensive (loss) income	(40,942)	(34,986)	47,201
Ending balance	1,207,624	1,294,645	1,109,265
Total
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(7,177)	27,809	(19,392)
Total other comprehensive (loss) income	(40,942)	(34,986)	47,201
Ending balance	(48,119)	(7,177)	27,809
Change in Unrealized Gain (Loss) on Cash Flow Hedges
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(945)	2,319	513
Tax expense	0	719	(415)
Reclassification of loss from accumulated other comprehensive income (loss), after tax	(3,688)	(3,922)	1,724
Other comprehensive income before reclassifications, net of tax	(3,688)	(3,203)	1,309
Reclassification of loss from accumulated other comprehensive income (loss), before tax	5,599	(75)	655
Reclassification of tax benefit	0	14	(158)
Reclassification of loss from accumulated other comprehensive income (loss), after tax	5,599	(61)	497
Total other comprehensive (loss) income	1,911	(3,264)	1,806
Ending balance	966	(945)	2,319
Foreign Currency Translation Adjustments
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(6,232)	25,490	(19,905)
Tax expense	0	0	0
Reclassification of loss from accumulated other comprehensive income (loss), after tax	(42,853)	(31,722)	45,395
Other comprehensive income before reclassifications, net of tax	(42,853)	(31,722)	45,395
Reclassification of loss from accumulated other comprehensive income (loss), before tax	0	0	0
Reclassification of tax benefit	0	0	0
Reclassification of loss from accumulated other comprehensive income (loss), after tax	0	0	0
Total other comprehensive (loss) income	(42,853)	(31,722)	45,395
Ending balance	$ (49,085)	$ (6,232)	$ 25,490

Stock-Based Plans - Narrative (

Stock-Based Plans - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for grant (in shares)	317,200
Stock-based compensation expense	$ 44,809	$ 40,564	$ 35,089
Continuing Operations
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 44,809	40,564	35,089
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period (in years)	2 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period (in years)	4 years
Employee stock purchase plan | Continuing Operations
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 1,192	1,505	1,224
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period (in years)	3 years
Market performance-based restricted stock units | Continuing Operations
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 4,651	3,522	3,200
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period (in years)	3 years
Operating performance-based restricted stock units | Continuing Operations
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 3,338	$ 3,434	$ (370)
Share-Based Payment Arrangement, Option | 2022 Incentive Award Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for grant (in shares)	1,900,000
Other Than Option, Awards | 2022 Incentive Award Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for grant (in shares)	1,137,785

Stock-Based Plans - Allocation

Stock-Based Plans - Allocation of Share Based Compensation Costs by Expense Category (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Employee Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 44,809	$ 40,564	$ 35,089
Income tax benefit	706	588	992
Total expense, net of income tax benefit	44,103	39,976	34,097
Continuing Operations
Employee Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	44,809	40,564	35,089
Continuing Operations | Cost of goods sold
Employee Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	1,455	2,451	1,898
Continuing Operations | Selling, general and administrative
Employee Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	35,638	29,449	29,661
Continuing Operations | Research and development
Employee Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 7,716	$ 8,664	$ 3,530

Stock-Based Plans - Allocatio_2

Stock-Based Plans - Allocation of Share-Based Compensation Costs by Type of Arrangement (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	$ 44,809	$ 40,564	$ 35,089
Continuing Operations
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	44,809	40,564	35,089
Continuing Operations | Service-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	21,563	19,614	18,320
Continuing Operations | Service-based stock appreciation rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	14,065	12,489	12,715
Continuing Operations | Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	4,651	3,522	3,200
Continuing Operations | Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	3,338	3,434	(370)
Continuing Operations | Employee stock purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	$ 1,192	$ 1,505	$ 1,224

Stock-Based Plans - Schedule of

Stock-Based Plans - Schedule of Stock-Based Compensation Cost Unrecognized (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Cost	$ 69,631
Weighted Average Remaining Vesting Period (in years)	2 years 3 months 10 days
Service-based stock appreciation rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Cost	$ 25,886
Weighted Average Remaining Vesting Period (in years)	2 years 7 months 9 days
Service-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Cost	$ 33,823
Weighted Average Remaining Vesting Period (in years)	2 years 5 months 26 days
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Cost	$ 9,922
Weighted Average Remaining Vesting Period (in years)	1 year 8 months 26 days

Stock-Based Plans - Schedule _2

Stock-Based Plans - Schedule of Share-Option Valuation Assumptions (Details)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend rate	0%	0%	0%
Risk-free interest rate	2.50%	1%	0.40%
Expected term	5 years 3 months 18 days	5 years 7 months 6 days
Expected volatility at grant date	42.20%	42.10%	39.50%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term			5 years 4 months 24 days

Stock-Based Plans - Schedule _3

Stock-Based Plans - Schedule of Share-Based Compensation, Stock Options, Rollforward (Details) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($) $ / shares shares
Number of Optioned Shares
Outstanding - beginning of period, shares (in shares) | shares	2,634,373
Granted, shares (in shares) | shares	553,050
Exercised, shares (in shares) | shares	(93,191)
Forfeited, shares (in shares) | shares	(150,881)
Expired, shares (in shares) | shares	(136,515)
Outstanding - end of period, shares (in shares) | shares	2,806,836
Fully vested and exercisable - end of year (shares) | shares	1,460,162
Fully vested and expected to vest - end of period (shares) | shares	2,756,467
Wtd. Avg. Exercise Price
Beginning of period (in dollars per share) | $ / shares	$ 65.94
Granted (in dollars per share) | $ / shares	82.04
Exercised (in dollars per share) | $ / shares	48.86
Forfeited (in dollars per share) | $ / shares	67.46
Expired (in dollars per share) | $ / shares	89.41
End of period (in dollars per share) | $ / shares	68.46
Fully vested and exercisable - end of year (in dollars per share) | $ / shares	67.43
Fully vested and expected to vest - end of year (in dollars per share) | $ / shares	$ 68.35
Wtd. Avg. Remaining Contractual Term (years)
Outstanding — as of December 31, 2022	6 years 8 months 1 day
Fully vested and exercisable — end of year	5 years 2 months 26 days
Fully vested and expected to vest - end of year	6 years 7 months 20 days
Aggregate Intrinsic Value (in thousands)
Outstanding — as of December 31, 2022 | $	$ 10,070
Fully vested and exercisable — end of year | $	5,494
Fully vested and expected to vest — end of year | $	$ 9,979

Stock-Based Plans - Summary of

Stock-Based Plans - Summary of Share-Based Compensation, Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-Based Payment Arrangement [Abstract]
Weighted average grant date fair value of SARs granted during the year (in dollars per share)	$ 34.13	$ 29.22	$ 15.73
Aggregate intrinsic value of SARs and stock options exercised during the year (in thousands)	$ 2,143	$ 12,223	$ 773

Stock-Based Plans - Schedule _4

Stock-Based Plans - Schedule of Restricted Stock Service-Based Rollforward (Details) - Service-based restricted stock units - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Number of Shares
Non-vested shares, beginning of year (in shares)	791,157
Granted (in shares)	328,980
Vested, shares (in shares)	(298,865)
Forfeited, shares (in shares)	(79,380)
Non-vested shares, end of year (in shares)	741,892	791,157
Wtd. Avg. Grant Date Fair Value
Balance beginning of year (in dollars per share)	$ 64.53
Granted (in dollars per share)	76.35	$ 74.17	$ 44.28
Vested (in dollars per share)	68.11
Forfeited (in dollars per share)	64.85
Balance end of year (in dollars per share)	$ 68.02	$ 64.53

Stock-Based Plans - Summary o_2

Stock-Based Plans - Summary of Restricted Stock Service-Based Activity (Details) - Service-based restricted stock units - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average grant date fair value of performance-based restricted share units granted during the year (per share)	$ 76.35	$ 74.17	$ 44.28
Aggregate fair value of performance-based restricted share units that vested during the year (in thousands)	$ 22,793	$ 21,501	$ 13,674

Stock-Based Plans - Schedule _5

Stock-Based Plans - Schedule of Performance-Based Restricted Stock and Restricted Stock Units Rollforward (Details) - Operating performance-based restricted stock units - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Number of Shares
Non-vested shares, beginning of year (in shares)	345,944
Granted (in shares)	88,354
Vested, shares (in shares)	(11,340)
Forfeited, shares (in shares)	(11,474)
Performance adjustments (in shares)	(80,950)
Non-vested shares, end of year (in shares)	330,534	345,944
Wtd. Avg. Grant Date Fair Value
Balance beginning of year (in dollars per share)	$ 68.36
Granted (in dollars per share)	92.53	$ 89.29	$ 41.70
Vested (in dollars per share)	95.13
Forfeited (in dollars per share)	41.70
Performance adjustments (in dollars per share)	91.58
Balance end of year (in dollars per share)	$ 70.45	$ 68.36

Stock-Based Plans - Summary o_3

Stock-Based Plans - Summary of Performance-Based Restricted Stock and Restricted Stock Unit Activity (Details) - Operating performance-based restricted stock units - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average grant date fair value of performance-based restricted share units granted during the year (per share)	$ 92.53	$ 89.29	$ 41.70
Aggregate fair value of performance-based restricted share units that vested during the year (in thousands)	$ 877	$ 8,268	$ 4,106

Employee Retirement Plans - Cha

Employee Retirement Plans - Change in Benefit Obligations and Funded Status (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Change in plan assets:
Fair value of plan assets at beginning of year	$ 8,010
Employer contributions	600	$ 700	$ 1,600
Fair value of plan assets at end of year	5,502	8,010
U.S. | Pension Plan
Defined Benefit Plan Disclosure [Line Items]
Accumulated benefit obligations at year end	9,790	12,578	13,085
Change in projected benefit obligation:
Projected benefit obligation at beginning of year	12,578	13,085	11,232
Interest cost	254	224	290
Plan settlement	(1,369)	(972)	(384)
Actuarial gain	(1,361)	527	2,225
Benefits paid	(312)	(286)	(278)
Projected benefit obligation at end of year	9,790	12,578	13,085
Change in plan assets:
Fair value of plan assets at beginning of year	8,020	8,688	7,574
Actual return on plan assets	(1,189)	189	646
Employer contributions	367	401	1,130
Plan settlement	(1,369)	(972)	(384)
Benefits paid	(313)	(286)	(278)
Fair value of plan assets at end of year	5,516	8,020	8,688
Funded status at end of year:
Underfunded status of the plans	4,274	4,558	4,397
Amounts recognized on the consolidated balance sheets consist of:
Non-current liabilities	4,274	4,558	4,397
Recognized liability	4,274	4,558	4,397
Non-U.S. | Pension Plan
Defined Benefit Plan Disclosure [Line Items]
Accumulated benefit obligations at year end	8,248	10,522	12,091
Change in projected benefit obligation:
Projected benefit obligation at beginning of year	10,817	13,039	18,087
Service cost	259	354	691
Interest cost	83	56	121
Actuarial gain	(831)	(1,372)	(208)
Benefits paid	(1,060)	(294)	(1,245)
Reclassified to liabilities held for sale	0	0	(6,012)
Foreign currency exchange rate changes and other	(736)	(966)	1,605
Projected benefit obligation at end of year	8,532	10,817	13,039
Change in plan assets:
Fair value of plan assets at beginning of year	3,142	2,816	3,423
Actual return on plan assets	(80)	61	52
Employer contributions	265	302	454
Benefits paid	(37)	(78)	(290)
Reclassified to liabilities held for sale	0	0	(1,018)
Foreign currency exchange rate changes and other	(58)	41	195
Fair value of plan assets at end of year	3,232	3,142	2,816
Funded status at end of year:
Underfunded status of the plans	5,300	7,675	10,223
Amounts recognized on the consolidated balance sheets consist of:
Non-current liabilities	5,300	7,675	10,223
Recognized liability	$ 5,300	$ 7,675	$ 10,223

Employee Retirement Plans - Net

Employee Retirement Plans - Net Periodic Benefit Cost of the Plans (Details) - Pension Plan - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
U.S.
Defined Benefit Plan Disclosure [Line Items]
Interest cost	$ 254	$ 224	$ 290
Expected return on plan assets	(298)	(358)	(318)
Settlement and curtailment loss	731	471	180
Amortization of net actuarial loss	262	264	182
Net periodic benefit cost	949	601	334
Non-U.S.
Defined Benefit Plan Disclosure [Line Items]
Service cost	259	354	691
Interest cost	83	56	121
Expected return on plan assets	80	(61)	(52)
Amortization of net actuarial loss	(831)	(1,372)	(208)
Net periodic benefit cost	$ (409)	$ (1,023)	$ 552

Employee Retirement Plans - Ass

Employee Retirement Plans - Assumptions Used (Details)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
U.S.
Weighted-average assumptions used to determine benefit obligation:
Discount rate	5.10%	2.41%	1.91%
Weighted-average assumptions used to determine net periodic benefit cost:
Discount rate	2.41%	1.91%	2.88%
Expected return on plan assets	5%	5%	5%
Non-U.S. | Minimum
Weighted-average assumptions used to determine benefit obligation:
Discount rate	0.45%	0.15%	0.23%
Rate of compensation increase	2.50%	2.50%	2.50%
Weighted-average assumptions used to determine net periodic benefit cost:
Discount rate	0.45%	0.15%	0.23%
Rate of compensation increase	2.50%	2.50%	2.50%
Non-U.S. | Maximum
Weighted-average assumptions used to determine benefit obligation:
Discount rate	3.70%	1%	0.35%
Rate of compensation increase	3.50%	3%	3%
Weighted-average assumptions used to determine net periodic benefit cost:
Discount rate	3.70%	1%	0.35%
Rate of compensation increase	3.50%	3%	3%

Employee Retirement Plans - Tar

Employee Retirement Plans - Target Asset Allocation (Details) - U.S.	Dec. 31, 2022
Equity securities
Defined Benefit Plan Disclosure [Line Items]
Target allocation percentage	29%
Debt securities
Defined Benefit Plan Disclosure [Line Items]
Target allocation percentage	70%
Other
Defined Benefit Plan Disclosure [Line Items]
Target allocation percentage	1%

Employee Retirement Plans - Fai

Employee Retirement Plans - Fair Value of Retirement Benefit Plan Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	$ 5,502	$ 8,010
Level 1
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	68	82
Level 2
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	5,434	7,928
Level 3
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0	0
Equity mutual funds
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	1,591	2,341
Equity mutual funds | Level 1
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0	0
Equity mutual funds | Level 2
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	1,591	2,341
Equity mutual funds | Level 3
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0	0
Fixed income mutual funds
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	3,843	5,587
Fixed income mutual funds | Level 1
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0	0
Fixed income mutual funds | Level 2
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	3,843	5,587
Fixed income mutual funds | Level 3
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0	0
Money market funds and cash
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	68	82
Money market funds and cash | Level 1
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	68	82
Money market funds and cash | Level 2
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0	0
Money market funds and cash | Level 3
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	$ 0	$ 0

Employee Retirement Plans - Nar

Employee Retirement Plans - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Retirement Benefits [Abstract]
Employer contributions	$ 0.6	$ 0.7	$ 1.6
Estimated future contributions	0.5
Defined contribution plan expense	$ 9	$ 10.2	$ 11.8

Employee Retirement Plans - Exp

Employee Retirement Plans - Expected Benefit Payments (Details) $ in Thousands	Dec. 31, 2022 USD ($)
U.S.
Defined Benefit Plan Disclosure [Line Items]
2023	$ 3,820
2024	688
2025	853
2026	908
2027	673
2028 - 2032	2,196
Non-U.S.
Defined Benefit Plan Disclosure [Line Items]
2023	740
2024	589
2025	675
2026	634
2027	730
2028 - 2032	$ 3,769

Income Taxes - Components and P

Income Taxes - Components and Provision for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Deferred:
Total income tax expense (benefit) from continuing operations	$ 11,051	$ 11,198	$ (960)
Continuing Operations
Income (loss) from continuing operations before income taxes:
Non-U.S.	22,570	22,094	(262,501)
U.S.	(97,712)	(146,566)	(85,521)
(Loss) income from continuing operations before tax	(75,142)	(124,472)	(348,022)
Current:
Non-U.S.	4,782	4,296	2,899
U.S.	4,860	4,050	(41,010)
Current income tax expense	9,642	8,346	(38,111)
Deferred:
Non-U.S.	1,409	2,852	37,151
Total income tax expense (benefit) from continuing operations	$ 11,051	$ 11,198	$ (960)

Income Taxes - Effective Income

Income Taxes - Effective Income Tax Rate Reconciliation (Details)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Statutory tax rate at UK Rate	19%	19%	19%
Deferred tax valuation allowance	(18.80%)	(47.70%)	(34.90%)
Foreign tax rate differential	10.60%	7.10%	6.60%
U.S. state and local tax expense, net of federal benefit	(1.40%)	(0.30%)	1.50%
Effect of changes in tax rate	6.20%	18.90%	2.20%
Write-off/impairment of investments	(27.60%)	(1.80%)	1.80%
Reserve for uncertain tax positions	0%	0%	0.80%
Research and development tax credits	1.20%	0.30%	0.90%
Base erosion anti-abuse tax	(2.90%)	(3.10%)	(0.70%)
Foreign tax withholding and credits	0%	(0.20%)	(0.20%)
CARES Act rate differential	0%	0%	2.80%
Disallowable professional fees	(0.40%)	(1.50%)	0%
Other, net	(0.60%)	0.30%	0.50%
Effective tax rate	(14.70%)	(9.00%)	0.30%

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Valuation allowance	$ 264,800	$ 245,000
Tax positions related to prior years for settlement with tax authorities	0	1,434	$ 13,989
Income tax penalties and interest accrued	300	$ 200	$ 400
Unrecognized tax benefits that would impact effective tax rate	1,600
Amount of possible decrease in unrecognized tax benefits in the next 12 months	$ 1,000

Income Taxes - Significant Comp

Income Taxes - Significant Components of Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Deferred tax assets:
Deferred R&D	$ 29,796	$ 0
Deferred tax liabilities:
Net deferred tax assets	1,384	2,197
Net deferred tax liabilities	8,516	7,728
Continuing Operations
Deferred tax assets:
Net operating loss carryforwards	142,456	152,491
Tax credit carryforwards	41,918	40,931
Interest expense carryforward	65,497	65,141
Accruals and reserves	35,132	36,796
Deferred compensation	16,081	13,262
Inventories	9,073	8,844
Other	6,898	19,119
Gross deferred tax assets	346,851	336,584
Valuation allowance	(264,754)	(244,978)
Net deferred tax assets	82,097	91,606
Deferred tax liabilities:
Property, equipment & intangible assets	(76,419)	(70,573)
Gain on sale of intellectual property	(12,810)	(26,564)
Gross deferred tax liabilities:	(89,229)	(97,137)
Net deferred tax liabilities	$ (7,132)	$ (5,531)

Income Taxes - Operating Loss a

Income Taxes - Operating Loss and Tax Credit Carryforwards (Details) $ in Thousands	Dec. 31, 2022 USD ($)
Operating Loss Carryforwards [Line Items]
Gross Amount	$ 733,435
Tax Benefit	184,387
Indefinite
Operating Loss Carryforwards [Line Items]
Tax Benefit	119,890
Various Tax Expiration Years
Operating Loss Carryforwards [Line Items]
Tax Benefit	64,497
Europe
Operating Loss Carryforwards [Line Items]
Gross Amount	429,156
Tax Benefit	104,075
Europe | Indefinite
Operating Loss Carryforwards [Line Items]
Tax Benefit	104,075
Europe | 2026 - 2036
Operating Loss Carryforwards [Line Items]
Tax Benefit	0
United States | U.S. State | Research Tax Credit Carryforward
Operating Loss Carryforwards [Line Items]
Tax Benefit	7,108
United States | U.S. Federal
Operating Loss Carryforwards [Line Items]
Tax Benefit	15,850
United States | U.S. Federal | Research Tax Credit Carryforward
Operating Loss Carryforwards [Line Items]
Tax Benefit	17,690
United States | U.S. Federal
Operating Loss Carryforwards [Line Items]
Gross Amount	112,259
Tax Benefit	23,574
United States | U.S. State
Operating Loss Carryforwards [Line Items]
Gross Amount	180,411
Tax Benefit	11,076
United States | Indefinite | U.S. State | Research Tax Credit Carryforward
Operating Loss Carryforwards [Line Items]
Tax Benefit	1,280
United States | Indefinite | U.S. Federal
Operating Loss Carryforwards [Line Items]
Tax Benefit	8,474
United States | Indefinite | U.S. State
Operating Loss Carryforwards [Line Items]
Tax Benefit	2,349
United States | 2021 - 2036 | U.S. Federal
Operating Loss Carryforwards [Line Items]
Tax Benefit	15,100
United States | 2021 - 2040 | U.S. State
Operating Loss Carryforwards [Line Items]
Tax Benefit	8,727
United States | 2025 - 2029 | U.S. Federal
Operating Loss Carryforwards [Line Items]
Tax Benefit	15,850
United States | 2021 - 2040 | U.S. Federal | Research Tax Credit Carryforward
Operating Loss Carryforwards [Line Items]
Tax Benefit	17,690
United States | 2030 - 2040 | U.S. State | Research Tax Credit Carryforward
Operating Loss Carryforwards [Line Items]
Tax Benefit	5,828
South America
Operating Loss Carryforwards [Line Items]
Gross Amount	11,183
Tax Benefit	3,664
South America | Indefinite
Operating Loss Carryforwards [Line Items]
Tax Benefit	3,410
South America | 2030
Operating Loss Carryforwards [Line Items]
Tax Benefit	254
Far East
Operating Loss Carryforwards [Line Items]
Gross Amount	426
Tax Benefit	79
Far East | Indefinite
Operating Loss Carryforwards [Line Items]
Tax Benefit	27
Far East | 2025 - 2030
Operating Loss Carryforwards [Line Items]
Tax Benefit	52
Non-U.S.
Operating Loss Carryforwards [Line Items]
Tax Benefit	1,271
Non-U.S. | Indefinite
Operating Loss Carryforwards [Line Items]
Tax Benefit	275
Non-U.S. | 2021 - 2032
Operating Loss Carryforwards [Line Items]
Tax Benefit	$ 996

Income Taxes - Schedule of Unre

Income Taxes - Schedule of Unrecognized Tax Benefits Roll-Forward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits, balance at beginning of year	$ 1,741	$ 3,433	$ 15,995
Tax positions related to prior years for settlement with tax authorities	0	(1,434)	(13,989)
Impact of foreign currency exchange rates	(101)	(258)
Impact of foreign currency exchange rates			1,427
Unrecognized tax benefits, balance at end of year	$ 1,640	$ 1,741	$ 3,433

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Basic weighted average shares outstanding (in shares)	53,472	50,633	48,592
Diluted weighted average shares outstanding (in shares)	53,472	50,633	48,592
Share-based Payment Arrangement
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share amount (in shares)	3,900	3,900	4,100

Geographic and Segment Inform_3

Geographic and Segment Information - Narrative (Details)	12 Months Ended
	Dec. 31, 2022 geographic_region segment
Segment Reporting [Abstract]
Number of reportable segments | segment	3
Number of geographic regions in which entity operates | geographic_region	3

Geographic and Segment Inform_4

Geographic and Segment Information - Revenue by Operating Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Segment Reporting Information [Line Items]
Net revenue	$ 1,021,805	$ 1,035,365	$ 934,241
U.S.
Segment Reporting Information [Line Items]
Net revenue	571,558	571,299	468,634
Europe
Segment Reporting Information [Line Items]
Net revenue	178,802	201,524	193,367
Rest of World
Segment Reporting Information [Line Items]
Net revenue	271,445	262,542	272,240
United Kingdom
Segment Reporting Information [Line Items]
Net revenue	32,300	35,800	29,700
Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	500,314	482,979	446,732
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	476,993	456,172	354,444
Operating Segments | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	39,301	55,459	42,321
Operating Segments | U.S. | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	159,489	154,073	132,543
Operating Segments | U.S. | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	374,542	358,476	282,509
Operating Segments | U.S. | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	37,527	53,821	41,094
Operating Segments | Europe | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	127,064	134,562	122,062
Operating Segments | Europe | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	50,291	51,435	39,019
Operating Segments | Europe | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	1,447	1,120	1,027
Operating Segments | Rest of World | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	213,761	194,344	192,127
Operating Segments | Rest of World | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	52,160	46,261	32,916
Operating Segments | Rest of World | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	327	518	200
Other
Segment Reporting Information [Line Items]
Net revenue	5,197	40,755	90,744
Other | U.S.
Segment Reporting Information [Line Items]
Net revenue	0	4,929	12,488
Other | Europe
Segment Reporting Information [Line Items]
Net revenue	0	14,407	31,259
Other | Rest of World
Segment Reporting Information [Line Items]
Net revenue	$ 5,197	$ 21,419	$ 46,997

Geographic and Segment Inform_5

Geographic and Segment Information - Reconciliation of Segment Income (Details) - USD ($) $ in Thousands		3 Months Ended	12 Months Ended			87 Months Ended
	Dec. 02, 2020	Dec. 31, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2022
Segment Reporting Information [Line Items]
Reportable segments income (loss) before income taxes			$ (43,817)	$ 36,183	$ (220,683)
Operating loss from continuing operations			(76,752)	(784)	(273,899)
Interest expense			(48,250)	(50,151)	(40,837)
Loss on debt extinguishment			0	(60,238)	(1,407)
Foreign exchange and other income/(expense)			49,860	(13,299)	(31,879)
Loss from continuing operations before tax			(75,142)	(124,472)	(348,022)
Impairment of goodwill	$ 21,300		129,396	0	21,269	$ 193,100
Impairment of disposal group and loss on sale			0	0	180,160
Heart Valves
Segment Reporting Information [Line Items]
Impairment of goodwill					21,300
Impairment of disposal group and loss on sale					180,200
Continuing Operations
Segment Reporting Information [Line Items]
Other expenses			32,935	36,967	53,216
Cardiopulmonary
Segment Reporting Information [Line Items]
Loss contingency accrual provision			21,700	38,100	3,900
Advanced Circulatory Support
Segment Reporting Information [Line Items]
Impairment of goodwill			129,400
Saluggia, Italy
Segment Reporting Information [Line Items]
Loss contingency accrual provision		$ 42,200
Decommissioning provision					42,200
Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Impairment of goodwill			0		0
Operating Segments | Cardiopulmonary | Continuing Operations
Segment Reporting Information [Line Items]
Reportable segments income (loss) before income taxes			11,247	(6,429)	35,735
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Impairment of goodwill			0		0
Operating Segments | Neuromodulation | Continuing Operations
Segment Reporting Information [Line Items]
Reportable segments income (loss) before income taxes			172,775	169,499	109,273
Operating Segments | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Impairment of goodwill			129,396		0
Operating Segments | Advanced Circulatory Support | Continuing Operations
Segment Reporting Information [Line Items]
Reportable segments income (loss) before income taxes			(142,590)	2,195	(575)
Other
Segment Reporting Information [Line Items]
Impairment of goodwill			0		21,269
Other | Continuing Operations
Segment Reporting Information [Line Items]
Reportable segments income (loss) before income taxes			$ (85,249)	$ (129,082)	$ (365,116)

Geographic and Segment Inform_6

Geographic and Segment Information - Assets by Reportable Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Assets	$ 2,294,773	$ 2,200,951
Operating Segments | Cardiopulmonary | Continuing Operations
Segment Reporting Information [Line Items]
Assets	874,143	921,481
Operating Segments | Neuromodulation | Continuing Operations
Segment Reporting Information [Line Items]
Assets	646,633	646,394
Operating Segments | Advanced Circulatory Support | Continuing Operations
Segment Reporting Information [Line Items]
Assets	121,454	231,846
Other | Continuing Operations
Segment Reporting Information [Line Items]
Assets	$ 652,543	$ 401,230

Geographic and Segment Inform_7

Geographic and Segment Information - Expenditures by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Segment Reporting Information [Line Items]
Capital expenditures	$ 26,592	$ 22,313	$ 35,916
Operating Segments | Cardiopulmonary | Continuing Operations
Segment Reporting Information [Line Items]
Capital expenditures	13,828	14,824	20,975
Operating Segments | Neuromodulation | Continuing Operations
Segment Reporting Information [Line Items]
Capital expenditures	369	179	7,318
Operating Segments | Advanced Circulatory Support | Continuing Operations
Segment Reporting Information [Line Items]
Capital expenditures	1,773	1,326	733
Other | Continuing Operations
Segment Reporting Information [Line Items]
Capital expenditures	$ 10,622	$ 5,984	$ 6,890

Geographic and Segment Inform_8

Geographic and Segment Information - Property, Plant, and Equipment by Geographic Region (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	$ 147,187	$ 150,066
United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	63,458	60,852
Europe
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	79,654	85,313
Rest of World
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	$ 4,075	$ 3,901

Supplemental Financial Inform_3

Supplemental Financial Information - Inventories (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Receivables [Abstract]
Raw materials	$ 70,027	$ 43,958
Work-in-process	15,508	14,161
Finished goods	43,844	47,721
Inventories	129,379	105,840
Provision for obsolescence	$ 8,200	$ 8,900

Supplemental Financial Inform_4

Supplemental Financial Information - Property, Plant and Equipment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Total gross property, plant and equipment	$ 322,308	$ 311,851
Accumulated depreciation	(175,121)	(161,785)
Total Property, plant and equipment, net	147,187	150,066
Land
Property, Plant and Equipment [Line Items]
Total gross property, plant and equipment	14,637	15,099
Building and building improvements
Property, Plant and Equipment [Line Items]
Total gross property, plant and equipment	$ 80,611	79,475
Building and building improvements | Minimum
Property, Plant and Equipment [Line Items]
Lives in Years	5 years
Building and building improvements | Maximum
Property, Plant and Equipment [Line Items]
Lives in Years	36 years
Equipment, software, furniture and fixtures
Property, Plant and Equipment [Line Items]
Total gross property, plant and equipment	$ 206,892	195,919
Equipment, software, furniture and fixtures | Minimum
Property, Plant and Equipment [Line Items]
Lives in Years	2 years
Equipment, software, furniture and fixtures | Maximum
Property, Plant and Equipment [Line Items]
Lives in Years	10 years
Other
Property, Plant and Equipment [Line Items]
Total gross property, plant and equipment	$ 8,861	9,246
Other | Minimum
Property, Plant and Equipment [Line Items]
Lives in Years	5 years
Other | Maximum
Property, Plant and Equipment [Line Items]
Lives in Years	7 years
Capital investment in process
Property, Plant and Equipment [Line Items]
Total gross property, plant and equipment	$ 11,307	$ 12,112

Supplemental Financial Inform_5

Supplemental Financial Information - Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Receivables [Abstract]
Contract liabilities	$ 10,226	$ 8,419
Operating lease liabilities	9,379	11,261
Legal and other administrative costs	8,653	11,832
Research and development costs	7,020	5,329
Italian medical device payback law	6,414	5,533
Royalty accrual	3,950	3,611
Restructuring related liabilities	2,045	836
Provisions for agents, returns and other	1,678	2,535
Contingent consideration	0	11,552
Amount payable to Gyrus Capital S.A.	0	11,418
Other accrued expenses	26,230	16,611
Accrued liabilities, current, total	$ 75,595	$ 88,937

Supplemental Financial Inform_6

Supplemental Financial Information - Foreign Exchange and Other Gains/Losses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Derivative Instruments, Gain (Loss) [Line Items]
Investment revaluation	$ 0	$ 4,642	$ 0
Other derivative liabilities fair value adjustment	305	3,415	0
Foreign exchange rate fluctuations	378	(1,243)	(4,851)
Exchangeable Notes issuance costs	0	0	(2,482)
Interest income	4,697	435	131
Other	691	779	(2,788)
Total foreign exchange and other gains/(losses)	49,860	(13,299)	(31,879)
Other Derivative Liabilities
Derivative Instruments, Gain (Loss) [Line Items]
Exchangeable Notes fair value adjustment	0	4,290	(4,290)
Embedded Exchange Feature Derivative Liability
Derivative Instruments, Gain (Loss) [Line Items]
Exchangeable Notes fair value adjustment	96,025	(59,944)	(46,805)
Capped Call Derivative Asset
Derivative Instruments, Gain (Loss) [Line Items]
Capped call fair value adjustment	$ (52,236)	$ 34,327	$ 29,206

Supplemental Financial Inform_7

Supplemental Financial Information - Cash, Cash Equivalents, Restricted Cash (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Receivables [Abstract]
Cash and cash equivalents	$ 214,172	$ 207,992
Restricted cash	301,446	0
Cash, cash equivalents and restricted cash	$ 515,618	$ 207,992	$ 252,832	$ 61,137