LivaNova (LIVN) 10-Q 3 May 23 2023 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2023	Apr. 26, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
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 Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		53,768,134
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001639691

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Statement [Abstract]
Net revenue	$ 263,418	$ 240,175
Cost of sales	89,335	71,732
Gross profit	174,083	168,443
Operating expenses:
Selling, general and administrative	124,129	118,525
Research and development	49,986	40,918
Other operating expense	2,310	(505)
Operating (loss) income	(2,342)	9,505
Interest expense	(13,437)	(7,840)
Foreign exchange and other income/(expense)	25,547	3,904
Income before tax	9,768	5,569
Income tax expense	2,371	2,537
Losses from equity method investments	(27)	(39)
Net income	$ 7,370	$ 2,993
Basic income per share (in dollars per share)	$ 0.14	$ 0.06
Diluted income per share (in dollars per share)	$ 0.14	$ 0.06
Shares used in computing basic income per share (in shares)	53,617	53,300
Shares used in computing diluted income per share (in shares)	53,900	54,176

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 7,370	$ 2,993
Other comprehensive income (loss):
Net change in unrealized loss on derivatives	(966)	(695)
Tax effect	0	0
Net of tax	(966)	(695)
Foreign currency translation adjustment	8,053	(8,260)
Total other comprehensive income (loss)	7,087	(8,955)
Total comprehensive income (loss)	$ 14,457	$ (5,962)

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Current Assets:
Cash and cash equivalents	$ 214,340	$ 214,172
Restricted cash	308,618	301,446
Accounts receivable, net of allowance of $11,487 at March 31, 2023 and $11,862 at December 31, 2022	178,318	183,110
Inventories	142,453	129,379
Prepaid and refundable taxes	24,342	31,708
Prepaid expenses and other current assets	34,946	26,321
Total Current Assets	903,017	886,136
Property, plant and equipment, net	149,060	147,187
Goodwill	774,447	768,787
Intangible assets, net	364,056	368,559
Operating lease assets	36,339	35,830
Investments	21,471	16,266
Deferred tax assets	1,533	1,384
Long-term derivative assets	31,014	54,393
Other assets	13,951	16,231
Total Assets	2,294,888	2,294,773
Current Liabilities:
Current debt obligations	22,297	23,434
Accounts payable	75,730	74,310
Accrued liabilities and other	96,353	81,481
Current litigation provision liability	19,311	29,481
Taxes payable	22,279	16,505
Accrued employee compensation and related benefits	80,159	72,187
Total Current Liabilities	316,129	297,398
Long-term debt obligations	520,201	518,067
Contingent consideration	90,119	85,292
Deferred tax liabilities	8,627	8,516
Long-term operating lease liabilities	28,782	29,548
Long-term employee compensation and related benefits	16,134	16,804
Long-term derivative liabilities	41,285	85,675
Other long-term liabilities	46,270	45,849
Total Liabilities	1,067,547	1,087,149
Commitments and contingencies (Note 6)
Stockholders’ Equity:
Ordinary Shares, £1.00 par value: unlimited shares authorized; 53,854,241 shares issued and 53,763,715 shares outstanding at March 31, 2023; 53,851,979 shares issued and 53,564,664 shares outstanding at December 31, 2022	82,424	82,424
Additional paid-in capital	2,162,928	2,157,724
Accumulated other comprehensive loss	(41,032)	(48,119)
Accumulated deficit	(976,660)	(984,030)
Treasury stock at cost, 90,526 ordinary shares at March 31, 2023; 287,315 ordinary shares at December 31, 2022	(319)	(375)
Total Stockholders’ Equity	1,227,341	1,207,624
Total Liabilities and Stockholders’ Equity	$ 2,294,888	$ 2,294,773

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) $ in Thousands	Mar. 31, 2023 USD ($) shares	Mar. 31, 2023 £ / shares	Dec. 31, 2022 USD ($) shares	Dec. 31, 2022 £ / shares
Statement of Financial Position [Abstract]
Allowance for doubtful accounts | $	$ 11,487		$ 11,862
Ordinary shares, par value (in pounds per share) | £ / shares		£ 1		£ 1
Ordinary shares issued (in shares)	53,854,241		53,851,979
Ordinary shares outstanding (in shares)	53,763,715		53,564,664
Treasury stock (in shares)	90,526		287,315

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Operating Activities:
Net income	$ 7,370	$ 2,993
Non-cash items included in net income:
Remeasurement of derivative instruments	(26,281)	(1,355)
Stock-based compensation	10,579	10,256
Amortization	6,355	6,465
Depreciation	5,956	5,626
Amortization of debt issuance costs	5,019	4,412
Remeasurement of contingent consideration to fair value	4,827	(3,773)
Amortization of operating lease assets	2,642	2,653
Other	(184)	1,073
Changes in operating assets and liabilities:
Accounts receivable, net	7,558	1,494
Inventories	(11,342)	(9,637)
Other current and non-current assets	(3,838)	(1,953)
Accounts payable and accrued current and non-current liabilities	21,378	9,957
Taxes payable	972	709
Litigation provision liability	(10,254)	(3,097)
Net cash provided by operating activities	20,757	25,823
Investing Activities:
Purchases of property, plant and equipment	(7,685)	(5,215)
Purchase of investments	(5,136)	(278)
Other	1,337	11
Net cash used in investing activities	(11,484)	(5,482)
Financing Activities:
Repayments of short-term borrowings (maturities greater than 90 days)	(1,974)	0
Repayment of long-term debt obligations	(1,875)	0
Shares repurchased from employees for minimum tax withholding	(1,577)	(1,074)
Proceeds from long-term debt obligations	0	218,342
Payment of debt issuance costs	0	(2,426)
Other	191	35
Net cash (used in) provided by financing activities	(5,235)	214,877
Effect of exchange rate changes on cash, cash equivalents and restricted cash	3,302	(826)
Net increase in cash, cash equivalents and restricted cash	7,340	234,392
Cash, cash equivalents and restricted cash at beginning of period	515,618	207,992
Cash, cash equivalents and restricted cash at end of period	$ 522,958	$ 442,384

Unaudited Condensed Consolidate

Unaudited Condensed Consolidated Financial Statements	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Unaudited Condensed Consolidated Financial Statements	Note 1. Unaudited Condensed Consolidated Financial Statements Basis of Presentation The accompanying condensed consolidated financial statements of LivaNova as of, and for the three months ended March 31, 2023 and 2022, have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2022 has been derived from audited financial statements contained in LivaNova’s 2022 Form 10-K, but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries for the three months ended March 31, 2023, and are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying LivaNova’s 2022 Form 10-K. Macroeconomic Environment The current macroeconomic environment, including foreign exchange volatility, supply chain challenges, inflationary pressures, and geopolitical instability, has impacted and may continue to impact LivaNova’s business. LivaNova’s net revenue and profitability have been negatively affected by the unfavorable foreign currency exchange impact of the strengthened U.S. dollar against a number of currencies. Furthermore, LivaNova continues to experience supply chain delays and interruptions, labor shortages, inflationary pressures and logistical issues. Though, to date, the Company’s 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 LivaNova’s manufacturing facilities have increased substantially in the wake of inflation globally. The Company continues to respond to such challenges, and while LivaNova has business continuity plans in place, the impact of the ongoing challenges the Company is experiencing, along with their potential escalation, may adversely affect its business. In February 2022, Russia launched an invasion in Ukraine which caused the Company to assess its ability to sell in the market due to international sanctions, to consider the potential impact of raw material sourced from the region, and to determine whether LivaNova is able to transact in a compliant fashion. Although business across Russia, Ukraine and Belarus represented 1% of LivaNova’s total net revenue for 2022, the invasion of Ukraine has increased economic uncertainties, and a significant escalation or continuation of the conflict could have a material, global impact on the Company’s operating results. Reclassifications The Company has reclassified certain prior period amounts on the condensed consolidated balance sheets for comparative purposes. These reclassifications did not have a material effect on LivaNova’s financial condition. Significant Accounting Policies LivaNova’s significant accounting policies are detailed below and in “Note 2. Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies” and “Note 3. Revenue Recognition” of LivaNova’s 2022 Form 10-K.

Business Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Note 2. Business Combinations As of December 31, 2021, LivaNova owned a 3% investment in ALung, a privately held medical device company focused on creating advanced medical devices for treating respiratory failure. On May 2, 2022, LivaNova 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 LivaNova’s 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 the Company’s ACS business. The assets acquired, including goodwill, are recognized in LivaNova’s ACS segment. The goodwill for the ACS reporting unit was fully impaired during the third quarter of 2022. The Company’s condensed 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 the Company’s 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 3. Fair Value Measurements.”

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 3. Fair Value Measurements The Company reviews 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 three months ended March 31, 2023 and 2022. Assets and Liabilities Measured at Fair Value on a Recurring Basis The following tables provide information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of March 31, 2023 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (interest rate swaps) $ 900 $ — $ 900 $ — Derivative assets - capped call derivatives 31,014 — — 31,014 Convertible notes receivable 275 — — 275 $ 32,189 $ — $ 900 $ 31,289 Liabilities: Derivative liabilities - freestanding instruments (FX) $ 1,236 $ — $ 1,236 $ — Derivative liabilities - embedded exchange feature 41,285 — — 41,285 Contingent consideration arrangements 90,119 — — 90,119 $ 132,640 $ — $ 1,236 $ 131,404 Fair Value as of December 31, 2022 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (interest rate swap) $ 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 (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 The following table provides a reconciliation of the beginning and ending balances of recurring fair value measurements, using significant unobservable inputs (Level 3) (in thousands): Capped Call Derivative Asset Convertible Notes Receivable Embedded Exchange Feature Derivative Liability Contingent Consideration Liability Arrangements As of December 31, 2022 - long-term $ 54,393 $ 285 $ 85,675 $ 85,292 Changes in fair value (23,379) (10) (44,390) 4,827 Total at March 31, 2023 - long-term $ 31,014 $ 275 $ 41,285 $ 90,119 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 4. 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 LivaNova’s 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 condensed consolidated statements of income. The fair value of the embedded exchange feature derivative liability and the capped call derivative assets was $41.3 million and $31.0 million, respectively, as of March 31, 2023, and the stock price volatility was 40%. As of March 31, 2023, a 10% lower volatility, holding other inputs constant, would reduce the fair value for the embedded exchange feature derivative liability by $13.5 million and a 10% higher volatility, holding other inputs constant, would increase the fair value by $12.9 million. As of March 31, 2023, a 10% lower volatility, holding other inputs constant, would reduce the fair value for the capped call derivatives by $8.6 million and a 10% higher volatility, holding other inputs constant, would increase the fair value by $4.5 million. Contingent Consideration Arrangements The following table provides the fair value of Level 3 contingent consideration arrangements by acquisition (in thousands): March 31, 2023 December 31, 2022 ImThera $ 73,056 $ 69,389 ALung 17,063 15,903 $ 90,119 $ 85,292 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 earnouts are valued using projected sales from LivaNova’s internal strategic plan. These arrangements are Level 3 fair value measurements and include the following significant unobservable inputs as of March 31, 2023: ImThera Acquisition Valuation Technique Unobservable Input Inputs Regulatory milestone-based payment Discounted cash flow Discount rate 9.7% Probability of payment 85% Projected payment year 2025 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 13.8% - 14.1% Credit risk discount rate 10.0% - 10.6% 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 March 31, 2023: ALung Acquisition Valuation Technique Unobservable Input Inputs Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 9.3% - 10.4% Credit risk discount rate 9.1% - 10.2% Revenue volatility 30.7% Projected years of earnout 2023 - 2027

Financing Arrangements

Financing Arrangements	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Financing Arrangements	Note 4. Financing Arrangements The outstanding principal amount of long-term debt as of March 31, 2023 and December 31, 2022 was as follows (in thousands, except interest rates): March 31, 2023 December 31, 2022 Maturity Interest Rate Term Facilities $ 288,022 $ 289,294 July 2027 8.20% 2020 Cash Exchangeable Senior Notes 243,320 239,568 December 2025 3.00% Bank of America Merrill Lynch Banco Múltiplo S.A. 6,715 6,462 July 2023 16.20% Mediocredito Italiano 1,637 1,601 December 2023 0.50% - 6.59% Bank of America, U.S. 1,500 1,500 January 2025 7.74% Other 564 534 Total long-term facilities 541,758 538,959 Less current portion of long-term debt 21,557 20,892 Total long-term debt obligations $ 520,201 $ 518,067 Revolving Credit The outstanding principal amount of LivaNova’s short-term unsecured revolving credit agreements and other agreements with various banks was $0.7 million and $2.5 million as of March 31, 2023 and December 31, 2022, respectively, with an interest rate of 4.24% and loan terms ranging from overnight to 364 days, as of March 31, 2023. On August 13, 2021, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA as 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 senior secured multi-currency revolving credit facility to be made available to the borrower, referred to as the 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 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, as defined in the agreement. 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 March 31, 2023 and December 31, 2022, the applicable commitment fee percentage was 0.5% per annum. 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 March 31, 2023, the Company was in compliance with the financial covenants contained in its 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 March 31, 2023 and December 31, 2022. Bridge Loan Facility On February 24, 2022, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA entered into 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 condensed consolidated balance sheet was $308.6 million and $301.4 million as of March 31, 2023 and December 31, 2022, respectively. For additional information regarding the SNIA litigation, please refer to “Note 6. 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 $0.9 million for the three months ended March 31, 2022 and is included in interest expense on the condensed consolidated statement of income. 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 Incremental Facility Amendment No. 2. Incremental Facility 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 are available in one single drawing on or after July 6, 2022 until the date that is nine months after such date, together the Term Facilities. As of March 31, 2023, 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 March 31, 2023, the applicable margin over Adjusted SOFR was equal to 3.50% 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 March 31, 2023 and December 31, 2022, the applicable commitment fee percentage was equal to 0.50% 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 at March 31, 2023 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 March 31, 2023, the Company was in compliance with the financial covenants contained in the 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 $0.5 million for the three months ended March 31, 2023, and is included in interest expense on the condensed consolidated statement of income. The unamortized discount and issuance costs related to the Initial Term Facility as of March 31, 2023 was $8.2 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 $0.5 million for the three months ended March 31, 2023, and is included in interest expense on the condensed consolidated statement of income. The issuance costs related to the Delayed Draw Term Facility were fully amortized as of March 31, 2023. 2020 Cash Exchangeable Senior Notes On June 17, 2020, LivaNova’s 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. 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 at March 31, 2023 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 for the Notes was $3.8 million and $3.4 million for the three months ended March 31, 2023 and 2022, respectively, and is included in interest expense on the condensed consolidated statement of income. The unamortized discount related to the Notes as of March 31, 2023 and December 31, 2022 was $44.2 million and $47.9 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 during the quarterly period ending March 31, 2023. As a result, the Company has included its obligations from the Notes and the associated embedded exchange feature derivative as a long-term liability on the condensed consolidated balance sheet as of March 31, 2023. 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 condensed 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)” in the condensed consolidated statements of income. The fair value of the embedded exchange feature derivative liability was $41.3 million and $85.7 million as of March 31, 2023 and December 31, 2022, 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 expected generally 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 condensed 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 condensed consolidated statements of income. The fair

Derivatives and Risk Management

Derivatives and Risk Management	3 Months Ended
	Mar. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives and Risk Management	Note 5. Derivatives and Risk Management Due to the global nature of LivaNova’s operations, LivaNova is exposed to foreign currency exchange rate fluctuations. Historically, the Company has 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. LivaNova is also exposed to equity price risk in connection with its Notes, including exchange and settlement provisions based on the price of the Company’s 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 LivaNova’s ordinary shares, subject to a capped price per share. LivaNova does not enter into derivative contracts for speculative purposes. LivaNova measures all outstanding derivatives each period end at fair value and reports the fair value as either financial assets or liabilities on the condensed 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 the condensed consolidated statements of income as shown in the tables below, and interest rate swap gains and losses in AOCI are reclassified to interest expense on the condensed consolidated statements of income. The Company evaluates hedge effectiveness at inception. Cash flows from derivative contracts are reported as operating activities on LivaNova’s condensed consolidated statements of cash flows. Freestanding FX Derivative Contracts The gross notional amount of FX derivative contracts not designated as hedging instruments outstanding at March 31, 2023 and December 31, 2022 was $128.0 million and $154.5 million, respectively. These derivative contracts are designed to offset the FX effects in earnings of various intercompany loans and trade receivables. For these freestanding derivatives, LivaNova recorded net losses of $1.3 million for the three months ended March 31, 2023 and net gains of $1.0 million for the three months ended March 31, 2022. These gains and losses are included in foreign exchange and other income/(expense) on the condensed consolidated statements of income. Counterparty Credit Risk LivaNova is exposed to credit risk in the event of non-performance by the counterparties to the Company’s derivatives. The two counterparties to the capped call transactions are financial institutions. To limit its credit risk, LivaNova selected financial institutions with a minimum long-term investment grade credit rating. LivaNova’s exposure to the credit risk of the counterparties is not secured by any collateral. If a counterparty becomes subject to insolvency proceedings, the Company will become an unsecured creditor in those proceedings, with a claim equal to LivaNova’s exposure at that time under the capped call transactions with that counterparty. To manage credit risk with respect to its 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, LivaNova utilized FX derivative contracts, designed as cash flow hedges, to hedge the variability of cash flows associated with LivaNova’s 12-month U.S. dollar forecasts of revenues and costs denominated in British Pound, Japanese Yen and the Euro. The Company transferred to earnings from AOCI the gain or loss realized on the FX derivative contracts at the time of invoicing. Upon the settlement of LivaNova’s foreign currency cash flow hedges in the fourth quarter of 2022 and following an in-depth analysis of the utility of the Company’s cash flow hedging program, LivaNova discontinued its foreign currency cash flow hedging program. Interest Rate Risk LivaNova has entered into interest rate swaps, which qualify for and are designated as cash flow hedges, for a notional amount covering a portion of the Initial Term Facility’s outstanding principal 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 Company’s interest rate swaps expired on April 6, 2023. LivaNova has elected not to renew the interest rate swaps as interest expense associated with the Initial Term Facility is principally offset by holding a significant portion of the Initial Term Facility in a depository account, which earns a floating rate of interest. The gross notional amounts of open derivative contracts designated as cash flow hedges at March 31, 2023 and December 31, 2022 were as follows (in thousands): Description of Derivative Contract March 31, 2023 December 31, 2022 Interest rate swap contracts $ 210,000 $ 210,000 Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in OCI and the amount reclassified to earnings from AOCI were as follows (in thousands): Three Months Ended March 31, 2023 2022 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss (Losses) Gains Recognized in OCI Gains Reclassified from AOCI to Earnings Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ — $ — $ (642) $ 441 FX derivative contracts SG&A — — — (388) Interest rate swap contracts Interest expense (433) 533 — — $ (433) $ 533 $ (642) $ 53 The Company offsets fair value amounts associated with its derivative instruments on the condensed consolidated balance sheets that are executed with the same counterparty under master netting arrangements. 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 condensed consolidated balance sheets (in thousands): Asset Derivatives Liability Derivatives March 31, 2023 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Designated as Hedging Instruments: Interest rate swap contracts Prepaid expenses and other current assets $ 900 Total derivatives designated as hedging instruments 900 Derivatives Not Designated as Hedging Instruments: Capped call derivatives Long-term derivative assets 31,014 FX derivative contracts Accrued liabilities and other $ 1,236 Embedded exchange feature Long-term derivative liabilities 41,285 Total derivatives not designated as hedging instruments 31,014 42,521 Total derivatives $ 31,914 $ 42,521 Asset Derivatives Liability Derivatives December 31, 2022 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Designated as Hedging Instruments: Interest rate swap contracts Prepaid expenses and other current assets $ 1,333 Total derivatives designated as hedging instruments 1,333 Derivatives Not Designated as Hedging Instruments: Capped call derivatives Long-term derivative assets 54,393 FX derivative contracts Accrued liabilities and other $ 5,886 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 (1) For the classification of inputs used to evaluate the fair value of derivatives, refer to “Note 3. Fair Value Measurements.”

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 6. Commitments and Contingencies 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. The estimated liability as of March 31, 2023 was €34.1 million ($37.1 million), which represented the low end of the estimated range of loss of €34.1 million ($37.1 million) to €43.5 million ($47.3 million) as of March 31, 2023. The estimated liability as of December 31, 2022 was €34.2 million ($36.6 million). Product Liability Litigation The Company is currently involved in litigation involving LivaNova’s 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, LivaNova 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 May 3, 2023, including the cases encompassed in the settlement framework described above that have not yet been dismissed, the Company was 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 four cases in the process of settling. 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. At March 31, 2023 and December 31, 2022, the provision for these matters was $22.4 million and $32.5 million, respectively. While the amount accrued represents the Company’s best estimate for those filed and unfiled claims that the Company believes are both probable and estimable at this time, and which are a subset of the filed and unfiled claims worldwide of which LivaNova is currently aware, the actual liability for resolution of these matters may vary from the Company’s estimate. The remaining claims for which a provision has not been recorded are remote or the potential loss is not estimable at this time. Changes in the carrying amount of the litigation provision liability are as follows (in thousands): Total litigation provision liability at December 31, 2022 $ 32,487 Payments (11,568) Adjustments (1) 1,314 FX and other 137 Total litigation provision liability at March 31, 2023 22,370 Less current portion of litigation provision liability at March 31, 2023 19,311 Long-term portion of litigation provision liability at March 31, 2023 (2) $ 3,059 (1) Adjustments to the litigation provision are included within other operating expense on the condensed consolidated statements of income. (2) Included within other long-term liabilities on the condensed consolidated balance sheet. SNIA Environmental Liability Sorin was created as a result of a spin-off from SNIA in 2004, and in 2015, Sorin was merged into LivaNova. SNIA subsequently became insolvent, and 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 LivaNova is 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 $318,062 as of March 31, 2023) for legal fees. The Public Administrations appealed the 2016 Decision to the 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 $623.2 million as of March 31, 2023). LivaNova appealed the partial decision on liability to the Italian Supreme Court in August 2019. In 2021, the Court of Appeal delivered the remainder of its decision, ordering LivaNova to pay damages of approximately €453.6 million (approximately $494.1 million as of March 31, 2023). LivaNova 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 LivaNova providing a first demand bank guarantee of €270.0 million (approximately $294.1 million as of March 31, 2023) within 30 calendar days, and on March 21, 2022, LivaNova delivered the guarantee, thereby satisfying the condition. Refer to “Note 4. 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 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, LivaNova (in addition to Caffaro Brescia, and other non-LivaNova entities) received an Order from the Italian Ministry of the Environment requiring the Company 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 LivaNova’s alleged joint liability with SNIA for SNIA’s environmental liabilities. LivaNova’s response, dated February 16, 2021, disputes the grounds upon which the Order is based. LivaNova also appealed the Order in the Administrative Court in Brescia. LivaNova has not recognized a liability in connection with these related matters because any potential loss is not currently probable. 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 transcatheter mitral valve replacement program and the Company’s November 20, 2019 announcement that it was ending the 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. LivaNova intends 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 Litigation On July 29, 2022, LivaNova received a demand letter from Mitral for approximately €20.8 million ($22.7 million as of March 31, 2023) 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. The Company does 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 contractually capped at €8.0 million ($8.7 million as of March 31, 2023). On March 22, 2023, Mitral served a formal claim on LivaNova in the High Court of Justice Commercial Court (King’s Bench Division) alleging damages flowing from the aforementioned asserted breaches of warranties in the A&R Purchase Agreement. Although the claim is in excess of €20.8 million, Mitral acknowledges the €8.0 million cap. 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 March 2023, the Italian government published a decree whereby a company’s obligation to execute payback payments is suspended until June 30, 2023. LivaNova 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. LivaNova also filed appeals against the regions requesting payments. The Company has accrued for the law since 2015 based on market and product information. As of March 31, 2023 and December 31, 2022, the total amount reserved for this matter was $7.0 million and $6.4 million, respectively; however, the actual liability could vary. Other Matters Additionally, LivaNova is the subject of various pending or threatened legal actions and proceedings that arise in the ordinary course of LivaNova’s 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 LivaNova’s consolidated net income, financial position or liquidity.

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2023
Stockholders' Equity Note [Abstract]
Stockholders' Equity	Note 7. Stockholders' Equity The tables below present the condensed consolidated statements of stockholders’ equity as of and for the three months ended March 31, 2023 and 2022 (in thousands): Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive (Loss) Income Accumulated Deficit Total Stockholders' Equity (1) December 31, 2022 53,852 $ 82,424 $ 2,157,724 $ (375) $ (48,119) $ (984,030) $ 1,207,624 Stock-based compensation plans 2 — 5,204 56 — — 5,260 Net income — — — — — 7,370 7,370 Other comprehensive income — — — — 7,087 — 7,087 March 31, 2023 53,854 $ 82,424 $ 2,162,928 $ (319) $ (41,032) $ (976,660) $ 1,227,341 Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive (Loss) Income Accumulated Deficit Total Stockholders' Equity (1) December 31, 2021 53,762 $ 82,295 $ 2,117,961 $ (650) $ (7,177) $ (897,784) $ 1,294,645 Stock-based compensation plans 2 3 3,137 31 — — 3,171 Net income — — — — — 2,993 2,993 Other comprehensive loss — — — — (8,955) — (8,955) March 31, 2022 53,764 $ 82,298 $ 2,121,098 $ (619) $ (16,132) $ (894,791) $ 1,291,854 The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income (loss) for the three months ended March 31, 2023 and 2022 (in thousands): Change in Unrealized Gain (Loss) on Derivatives Foreign Currency Translation Adjustments Gain (Loss) (1) Total December 31, 2022 $ 966 $ (49,085) $ (48,119) Other comprehensive loss before reclassifications, before tax (433) 8,053 7,620 Tax benefit — — — Other comprehensive loss before reclassifications, net of tax (433) 8,053 7,620 Reclassification of gain from accumulated other comprehensive loss, before tax (533) — (533) Reclassification of tax benefit — — — Reclassification of gain from accumulated other comprehensive loss, after tax (533) — (533) Net current-period other comprehensive loss, net of tax (966) 8,053 7,087 March 31, 2023 $ — $ (41,032) $ (41,032) December 31, 2021 $ (945) $ (6,232) $ (7,177) Other comprehensive loss before reclassifications, before tax (642) (8,260) (8,902) Tax benefit — — — Other comprehensive loss before reclassifications, net of tax (642) (8,260) (8,902) Reclassification of loss from accumulated other comprehensive income, before tax (53) — (53) Reclassification of tax benefit — — — Reclassification of loss from accumulated other comprehensive income, after tax (53) — (53) Net current-period other comprehensive loss, net of tax (695) (8,260) (8,955) March 31, 2022 $ (1,640) $ (14,492) $ (16,132) (1) Taxes are not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned.

Stock-Based Incentive Plans

Stock-Based Incentive Plans	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Stock-Based Incentive Plans	Note 8. Stock-Based Incentive Plans During the three months ended March 31, 2023, LivaNova issued stock-based compensatory awards with terms approved by the Compensation Committee of LivaNova’s Board of Directors. The awards with service conditions generally vest ratably over four years and are subject to forfeiture unless service conditions are met. The market performance-based awards that were issued, cliff vest after three years subject to the rank of LivaNova’s total shareholder return for the three-year period ending December 31, 2025 relative to the total shareholder returns for a peer group of companies. The adjusted free cash flow and return on 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 the three-year period ending December 31, 2025. Compensation expense related to awards granted during 2023 for the three months ended March 31, 2023 was $0.1 million. Stock-based incentive plans compensation expense is as follows (in thousands): Three Months Ended March 31, 2023 2022 RSUs $ 5,717 $ 5,344 SARs 3,121 2,938 Market performance-based restricted stock units 881 851 Operating performance-based restricted stock units 570 785 Employee share purchase plan 290 338 Total stock-based compensation expense $ 10,579 $ 10,256 Stock-based compensation agreements issued during the three months ended March 31, 2023, representing potential shares and their weighted average grant date fair values by type is as follows (shares in thousands, fair value in dollars): Three Months Ended March 31, 2023 Shares Weighted Average Grant Date Fair Value Service-based SARs 974,204 $ 19.44 Service-based RSUs 459,818 $ 42.30 Market performance-based RSUs 94,561 $ 38.95 Operating performance-based RSUs 94,556 $ 42.30

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Note 9. Income Taxes LivaNova’s effective income tax rate for the three months ended March 31, 2023 was 24.3% compared with 45.6% for the three months ended March 31, 2022. LivaNova’s effective income tax rate fluctuates based on, among other factors, changes in pretax income in countries with varying statutory tax rates, valuation allowances, tax credits and incentives, and unrecognized tax benefits associated with uncertain tax positions. LivaNova continually assesses the realizability of its worldwide deferred tax asset and valuation allowance positions, and when the need arises, the Company establishes or releases valuation allowances accordingly. The decrease in the effective tax rate for the three months ended March 31, 2023 as compared to the same prior year period was primarily attributable to changes in valuation allowances and year-over-year changes in income before tax in countries with varying statutory tax rates. LivaNova operates in multiple jurisdictions throughout the world, and its tax returns are periodically audited or subjected to review by tax authorities. As a result, there is an uncertainty in income taxes recognized in LivaNova’s financial statements. Tax benefits totaling $1.7 million and $1.6 million were unrecognized as of March 31, 2023 and December 31, 2022, respectively. 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 could decrease by up to approximately $1.0 million.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Earnings Per Share	Note 10. Earnings Per Share Reconciliation of the shares used in the basic and diluted earnings per share computations for the three months ended March 31, 2023 and 2022 are as follows (in thousands): Three Months Ended March 31, 2023 2022 Basic weighted average shares outstanding 53,617 53,300 Add effects of share-based compensation instruments (1) 283 876 Diluted weighted average shares outstanding 53,900 54,176 (1) Excluded from the computation of diluted earnings per share were stock options, SARs and restricted share units totaling 3.2 million and 2.2 million for the three months ended March 31, 2023 and 2022, respectively, because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Informat

Geographic and Segment Information	3 Months Ended
	Mar. 31, 2023
Segment Reporting [Abstract]
Geographic and Segment Information	Note 11. Geographic and Segment Information LivaNova identifies operating segments based on the way it manages, evaluates and internally reports its business activities for purposes of allocating resources, developing and executing its strategy, and assessing performance. LivaNova has three reportable segments: Cardiopulmonary, Neuromodulation and ACS. LivaNova’s 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. LivaNova’s 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 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 LivaNova’s aura6000 System for treating OSA. LivaNova’s Neuromodulation segment also includes costs associated with LivaNova’s former heart failure program, which, as previously disclosed, the Company began to wind down during the first quarter of 2023. LivaNova’s ACS segment is engaged in the development, production and sale of leading-edge temporary life support products. LivaNova’s ACS products, which comprise the LifeSPARC platform, 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. LivaNova’s 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. Net revenue of the Company’s reportable segments includes revenues from the sale of products that each reportable segment develops and manufactures or distributes. LivaNova defines segment income as operating income before merger and integration expense, restructuring expense and the amortization of intangibles. LivaNova operates under three geographic regions: U.S., Europe, and Rest of World. The table below presents net revenue by operating segment and geographic region (in thousands): Three Months Ended March 31, 2023 2022 Cardiopulmonary United States $ 36,114 $ 38,096 Europe (1) 36,283 32,067 Rest of World 59,675 46,912 132,072 117,075 Neuromodulation United States 94,489 87,210 Europe (1) 13,280 12,456 Rest of World 12,954 10,561 120,723 110,227 Advanced Circulatory Support United States 9,664 10,963 Europe (1) 80 603 Rest of World 98 117 9,842 11,683 Other United States — — Europe (1) — — Rest of World 781 1,190 781 1,190 Totals United States 140,267 136,269 Europe (1) 49,643 45,126 Rest of World 73,508 58,780 Total (2) $ 263,418 $ 240,175 (1) Includes countries in Europe where the Company has a direct sales presence. Countries where sales are made through distributors are included in “Rest of World.” (2) No single customer represented over 10% of the Company’s consolidated net revenue. No country’s net revenue exceeded 10% of the Company’s consolidated revenue except for the U.S. The table below presents a reconciliation of segment income to consolidated income before tax (in thousands): Three Months Ended March 31, 2023 2022 Cardiopulmonary $ 7,584 $ 6,895 Neuromodulation 27,006 37,478 Advanced Circulatory Support (6,449) (5,438) Other (1) (23,132) (23,082) Total reportable segment income 5,009 15,853 Other expenses (2) 7,351 6,348 Operating (loss) income (2,342) 9,505 Interest expense (13,437) (7,840) Foreign exchange and other income/(expense) 25,547 3,904 Income before tax $ 9,768 $ 5,569 (1) Other includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. (2) Other expenses primarily consist of amortization of intangible assets, merger and integration expense and restructuring expense. Assets by segment are as follows (in thousands): March 31, 2023 December 31, 2022 Cardiopulmonary $ 885,784 $ 874,143 Neuromodulation 642,467 646,633 Advanced Circulatory Support 118,120 121,454 Other 648,517 652,543 Total $ 2,294,888 $ 2,294,773 Capital expenditures by segment are as follows (in thousands): Three Months Ended March 31, 2023 2022 Cardiopulmonary $ 4,798 $ 1,829 Neuromodulation 359 84 Advanced Circulatory Support 137 684 Other 2,557 2,983 Total $ 7,851 $ 5,580 The changes in the carrying amount of goodwill by segment for the three months ended March 31, 2023 were as follows (in thousands): Cardiopulmonary Neuromodulation Total December 31, 2022 $ 370,033 $ 398,754 $ 768,787 Foreign currency adjustments 5,660 — 5,660 March 31, 2023 $ 375,693 $ 398,754 $ 774,447 Property, plant and equipment, net by geography are as follows (in thousands): March 31, 2023 December 31, 2022 United States $ 65,058 $ 63,458 Europe 79,797 79,654 Rest of World 4,205 4,075 Total $ 149,060 $ 147,187

Supplemental Financial Informat

Supplemental Financial Information	3 Months Ended
	Mar. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Supplemental Financial Information	Note 12. Supplemental Financial Information Inventories consisted of the following (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 80,054 $ 70,027 Work-in-process 18,500 15,508 Finished goods 43,899 43,844 $ 142,453 $ 129,379 As of March 31, 2023 and December 31, 2022, inventories included adjustments totaling $10.0 million and $8.2 million, respectively, to record balances at lower of cost or net realizable value. Accrued liabilities and other consisted of the following (in thousands): March 31, 2023 December 31, 2022 Legal and other administrative costs $ 15,403 $ 8,653 Contract liabilities 11,718 10,226 Operating lease liabilities 9,992 9,379 Interest payable 8,379 (76) Research and development costs 7,667 7,020 Italian medical device payback law 6,960 6,414 Royalty accrual 3,816 3,950 Provisions for agents, returns and other 2,428 1,678 Current derivative liabilities 1,236 5,886 Restructuring liabilities 798 2,045 Other accrued expenses 27,956 26,306 $ 96,353 $ 81,481 As of March 31, 2023 and December 31, 2022, contract liabilities totaling $15.5 million and $14.1 million, respectively, were included within accrued liabilities and other long-term liabilities on the condensed consolidated balance sheets. The table below presents the items included within “Foreign exchange and other income/(expense)” on the condensed consolidated statements of income (in thousands): Three Months Ended March 31, 2023 2022 Exchangeable Notes fair value adjustment (1) $ 44,390 $ 11,040 Capped call fair value adjustment (1) (23,379) (9,912) Foreign exchange rate fluctuations 222 2,791 Interest income 4,536 20 Other (222) (35) Foreign exchange and other income/(expense) $ 25,547 $ 3,904 (1) Refer to “Note 3. Fair Value Measurements” The table below presents a reconciliation of cash, cash equivalents and restricted cash reported on the condensed consolidated balance sheets that sum to the total of the amounts shown on the condensed consolidated statement of cash flows (in thousands): March 31, 2023 December 31, 2022 Cash and cash equivalents $ 214,340 $ 214,172 Restricted cash (1) 308,618 301,446 Cash, cash equivalents and restricted cash $ 522,958 $ 515,618 (1) Restricted cash represents funds held as collateral for the SNIA Litigation Guarantee. Refer to “Note 6. Commitments and Contingencies.”

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2023
Subsequent Events [Abstract]
Subsequent Events	Note 13. Subsequent Events On April 6, 2023, LivaNova drew $50 million under the Delayed Draw Term Facility. The Term Facilities have now been fully drawn. The proceeds are to be used for general corporate purposes. As previously disclosed, on April 9, 2021, LivaNova and Mitral 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. On April 9, 2023, Mitral provided notice to LivaNova, consistent with the terms of the Amended & Restated Purchase Agreement, that they would not exercise their right to purchase LSM.

Unaudited Condensed Consolida_2

Unaudited Condensed Consolidated Financial Statements (Policies)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated financial statements of LivaNova as of, and for the three months ended March 31, 2023 and 2022, have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2022 has been derived from audited financial statements contained in LivaNova’s 2022 Form 10-K, but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries for the three months ended March 31, 2023, and are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying LivaNova’s 2022 Form 10-K.
Reclassifications	ReclassificationsThe Company has reclassified certain prior period amounts on the condensed consolidated balance sheets for comparative purposes. These reclassifications did not have a material effect on LivaNova’s financial condition.
Derivatives	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 the condensed consolidated statements of income as shown in the tables below, and interest rate swap gains and losses in AOCI are reclassified to interest expense on the condensed consolidated statements of income. The Company evaluates hedge effectiveness at inception. Cash flows from derivative contracts are reported as operating activities on LivaNova’s condensed consolidated statements of cash flows.

Business Combinations (Tables)

Business Combinations (Tables)	3 Months Ended
	Mar. 31, 2023
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 LivaNova’s 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 the Company’s 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 9.7% Probability of payment 85% Projected payment year 2025 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 13.8% - 14.1% Credit risk discount rate 10.0% - 10.6% 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 March 31, 2023: ALung Acquisition Valuation Technique Unobservable Input Inputs Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 9.3% - 10.4% Credit risk discount rate 9.1% - 10.2% Revenue volatility 30.7% Projected years of earnout 2023 - 2027

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements on a Recurring Basis	The following tables provide information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of March 31, 2023 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (interest rate swaps) $ 900 $ — $ 900 $ — Derivative assets - capped call derivatives 31,014 — — 31,014 Convertible notes receivable 275 — — 275 $ 32,189 $ — $ 900 $ 31,289 Liabilities: Derivative liabilities - freestanding instruments (FX) $ 1,236 $ — $ 1,236 $ — Derivative liabilities - embedded exchange feature 41,285 — — 41,285 Contingent consideration arrangements 90,119 — — 90,119 $ 132,640 $ — $ 1,236 $ 131,404 Fair Value as of December 31, 2022 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (interest rate swap) $ 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 (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
Reconciliation of Beginning and Ending Balances of Recurring Fair Value Measurements	The following table provides a reconciliation of the beginning and ending balances of recurring fair value measurements, using significant unobservable inputs (Level 3) (in thousands): Capped Call Derivative Asset Convertible Notes Receivable Embedded Exchange Feature Derivative Liability Contingent Consideration Liability Arrangements As of December 31, 2022 - long-term $ 54,393 $ 285 $ 85,675 $ 85,292 Changes in fair value (23,379) (10) (44,390) 4,827 Total at March 31, 2023 - long-term $ 31,014 $ 275 $ 41,285 $ 90,119
Schedule of Fair Value of Contingent Consideration Arrangements by Acquisition	The following table provides the fair value of Level 3 contingent consideration arrangements by acquisition (in thousands): March 31, 2023 December 31, 2022 ImThera $ 73,056 $ 69,389 ALung 17,063 15,903 $ 90,119 $ 85,292
Significant Unobservable Inputs Related to Contingent Consideration	The sales-based earnout was valued using projected sales from the Company’s 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 9.7% Probability of payment 85% Projected payment year 2025 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 13.8% - 14.1% Credit risk discount rate 10.0% - 10.6% 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 March 31, 2023: ALung Acquisition Valuation Technique Unobservable Input Inputs Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 9.3% - 10.4% Credit risk discount rate 9.1% - 10.2% Revenue volatility 30.7% Projected years of earnout 2023 - 2027

Financing Arrangements (Tables)

Financing Arrangements (Tables)	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Schedule of Long-term Debt	The outstanding principal amount of long-term debt as of March 31, 2023 and December 31, 2022 was as follows (in thousands, except interest rates): March 31, 2023 December 31, 2022 Maturity Interest Rate Term Facilities $ 288,022 $ 289,294 July 2027 8.20% 2020 Cash Exchangeable Senior Notes 243,320 239,568 December 2025 3.00% Bank of America Merrill Lynch Banco Múltiplo S.A. 6,715 6,462 July 2023 16.20% Mediocredito Italiano 1,637 1,601 December 2023 0.50% - 6.59% Bank of America, U.S. 1,500 1,500 January 2025 7.74% Other 564 534 Total long-term facilities 541,758 538,959 Less current portion of long-term debt 21,557 20,892 Total long-term debt obligations $ 520,201 $ 518,067

Derivatives and Risk Manageme_2

Derivatives and Risk Management (Tables)	3 Months Ended
	Mar. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Notional Amounts of Derivative Contracts Designated Cash Flow Hedges	The gross notional amounts of open derivative contracts designated as cash flow hedges at March 31, 2023 and December 31, 2022 were as follows (in thousands): Description of Derivative Contract March 31, 2023 December 31, 2022 Interest rate swap contracts $ 210,000 $ 210,000
Schedule of Cash Flow Hedges Included in AOCI	Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in OCI and the amount reclassified to earnings from AOCI were as follows (in thousands): Three Months Ended March 31, 2023 2022 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss (Losses) Gains Recognized in OCI Gains Reclassified from AOCI to Earnings Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ — $ — $ (642) $ 441 FX derivative contracts SG&A — — — (388) Interest rate swap contracts Interest expense (433) 533 — — $ (433) $ 533 $ (642) $ 53
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 condensed consolidated balance sheets (in thousands): Asset Derivatives Liability Derivatives March 31, 2023 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Designated as Hedging Instruments: Interest rate swap contracts Prepaid expenses and other current assets $ 900 Total derivatives designated as hedging instruments 900 Derivatives Not Designated as Hedging Instruments: Capped call derivatives Long-term derivative assets 31,014 FX derivative contracts Accrued liabilities and other $ 1,236 Embedded exchange feature Long-term derivative liabilities 41,285 Total derivatives not designated as hedging instruments 31,014 42,521 Total derivatives $ 31,914 $ 42,521 Asset Derivatives Liability Derivatives December 31, 2022 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Designated as Hedging Instruments: Interest rate swap contracts Prepaid expenses and other current assets $ 1,333 Total derivatives designated as hedging instruments 1,333 Derivatives Not Designated as Hedging Instruments: Capped call derivatives Long-term derivative assets 54,393 FX derivative contracts Accrued liabilities and other $ 5,886 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 (1) For the classification of inputs used to evaluate the fair value of derivatives, refer to “Note 3. Fair Value Measurements.”

Commitments and Contingencies (

Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Litigation Provision Liabilities	Changes in the carrying amount of the litigation provision liability are as follows (in thousands): Total litigation provision liability at December 31, 2022 $ 32,487 Payments (11,568) Adjustments (1) 1,314 FX and other 137 Total litigation provision liability at March 31, 2023 22,370 Less current portion of litigation provision liability at March 31, 2023 19,311 Long-term portion of litigation provision liability at March 31, 2023 (2) $ 3,059 (1) Adjustments to the litigation provision are included within other operating expense on the condensed consolidated statements of income. (2) Included within other long-term liabilities on the condensed consolidated balance sheet.

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2023
Stockholders' Equity Note [Abstract]
Schedule of Stockholders Equity	The tables below present the condensed consolidated statements of stockholders’ equity as of and for the three months ended March 31, 2023 and 2022 (in thousands): Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive (Loss) Income Accumulated Deficit Total Stockholders' Equity (1) December 31, 2022 53,852 $ 82,424 $ 2,157,724 $ (375) $ (48,119) $ (984,030) $ 1,207,624 Stock-based compensation plans 2 — 5,204 56 — — 5,260 Net income — — — — — 7,370 7,370 Other comprehensive income — — — — 7,087 — 7,087 March 31, 2023 53,854 $ 82,424 $ 2,162,928 $ (319) $ (41,032) $ (976,660) $ 1,227,341 Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive (Loss) Income Accumulated Deficit Total Stockholders' Equity (1) December 31, 2021 53,762 $ 82,295 $ 2,117,961 $ (650) $ (7,177) $ (897,784) $ 1,294,645 Stock-based compensation plans 2 3 3,137 31 — — 3,171 Net income — — — — — 2,993 2,993 Other comprehensive loss — — — — (8,955) — (8,955) March 31, 2022 53,764 $ 82,298 $ 2,121,098 $ (619) $ (16,132) $ (894,791) $ 1,291,854
Schedule of Accumulated Other Comprehensive Income (Loss)	The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income (loss) for the three months ended March 31, 2023 and 2022 (in thousands): Change in Unrealized Gain (Loss) on Derivatives Foreign Currency Translation Adjustments Gain (Loss) (1) Total December 31, 2022 $ 966 $ (49,085) $ (48,119) Other comprehensive loss before reclassifications, before tax (433) 8,053 7,620 Tax benefit — — — Other comprehensive loss before reclassifications, net of tax (433) 8,053 7,620 Reclassification of gain from accumulated other comprehensive loss, before tax (533) — (533) Reclassification of tax benefit — — — Reclassification of gain from accumulated other comprehensive loss, after tax (533) — (533) Net current-period other comprehensive loss, net of tax (966) 8,053 7,087 March 31, 2023 $ — $ (41,032) $ (41,032) December 31, 2021 $ (945) $ (6,232) $ (7,177) Other comprehensive loss before reclassifications, before tax (642) (8,260) (8,902) Tax benefit — — — Other comprehensive loss before reclassifications, net of tax (642) (8,260) (8,902) Reclassification of loss from accumulated other comprehensive income, before tax (53) — (53) Reclassification of tax benefit — — — Reclassification of loss from accumulated other comprehensive income, after tax (53) — (53) Net current-period other comprehensive loss, net of tax (695) (8,260) (8,955) March 31, 2022 $ (1,640) $ (14,492) $ (16,132) (1) Taxes are not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned.

Stock-Based Incentive Plans (Ta

Stock-Based Incentive Plans (Tables)	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Schedule of Stock-based Incentive Plans	Stock-based incentive plans compensation expense is as follows (in thousands): Three Months Ended March 31, 2023 2022 RSUs $ 5,717 $ 5,344 SARs 3,121 2,938 Market performance-based restricted stock units 881 851 Operating performance-based restricted stock units 570 785 Employee share purchase plan 290 338 Total stock-based compensation expense $ 10,579 $ 10,256 Three Months Ended March 31, 2023 Shares Weighted Average Grant Date Fair Value Service-based SARs 974,204 $ 19.44 Service-based RSUs 459,818 $ 42.30 Market performance-based RSUs 94,561 $ 38.95 Operating performance-based RSUs 94,556 $ 42.30

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Schedule of Basic and Diluted Weighted-Average Shares Outstanding	Reconciliation of the shares used in the basic and diluted earnings per share computations for the three months ended March 31, 2023 and 2022 are as follows (in thousands): Three Months Ended March 31, 2023 2022 Basic weighted average shares outstanding 53,617 53,300 Add effects of share-based compensation instruments (1) 283 876 Diluted weighted average shares outstanding 53,900 54,176 (1) Excluded from the computation of diluted earnings per share were stock options, SARs and restricted share units totaling 3.2 million and 2.2 million for the three months ended March 31, 2023 and 2022, respectively, because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Inform_2

Geographic and Segment Information (Tables)	3 Months Ended
	Mar. 31, 2023
Segment Reporting [Abstract]
Revenue from External Customers by Geographic Areas	The table below presents net revenue by operating segment and geographic region (in thousands): Three Months Ended March 31, 2023 2022 Cardiopulmonary United States $ 36,114 $ 38,096 Europe (1) 36,283 32,067 Rest of World 59,675 46,912 132,072 117,075 Neuromodulation United States 94,489 87,210 Europe (1) 13,280 12,456 Rest of World 12,954 10,561 120,723 110,227 Advanced Circulatory Support United States 9,664 10,963 Europe (1) 80 603 Rest of World 98 117 9,842 11,683 Other United States — — Europe (1) — — Rest of World 781 1,190 781 1,190 Totals United States 140,267 136,269 Europe (1) 49,643 45,126 Rest of World 73,508 58,780 Total (2) $ 263,418 $ 240,175 (1) Includes countries in Europe where the Company has a direct sales presence. Countries where sales are made through distributors are included in “Rest of World.”
Schedule of Segment Reporting Information, by Segment	The table below presents a reconciliation of segment income to consolidated income before tax (in thousands): Three Months Ended March 31, 2023 2022 Cardiopulmonary $ 7,584 $ 6,895 Neuromodulation 27,006 37,478 Advanced Circulatory Support (6,449) (5,438) Other (1) (23,132) (23,082) Total reportable segment income 5,009 15,853 Other expenses (2) 7,351 6,348 Operating (loss) income (2,342) 9,505 Interest expense (13,437) (7,840) Foreign exchange and other income/(expense) 25,547 3,904 Income before tax $ 9,768 $ 5,569 (1) Other includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. (2) Other expenses primarily consist of amortization of intangible assets, merger and integration expense and restructuring expense. Assets by segment are as follows (in thousands): March 31, 2023 December 31, 2022 Cardiopulmonary $ 885,784 $ 874,143 Neuromodulation 642,467 646,633 Advanced Circulatory Support 118,120 121,454 Other 648,517 652,543 Total $ 2,294,888 $ 2,294,773 Capital expenditures by segment are as follows (in thousands): Three Months Ended March 31, 2023 2022 Cardiopulmonary $ 4,798 $ 1,829 Neuromodulation 359 84 Advanced Circulatory Support 137 684 Other 2,557 2,983 Total $ 7,851 $ 5,580
Schedule of Goodwill by Segment	The changes in the carrying amount of goodwill by segment for the three months ended March 31, 2023 were as follows (in thousands): Cardiopulmonary Neuromodulation Total December 31, 2022 $ 370,033 $ 398,754 $ 768,787 Foreign currency adjustments 5,660 — 5,660 March 31, 2023 $ 375,693 $ 398,754 $ 774,447
Long-lived Assets by Geographic Areas	Property, plant and equipment, net by geography are as follows (in thousands): March 31, 2023 December 31, 2022 United States $ 65,058 $ 63,458 Europe 79,797 79,654 Rest of World 4,205 4,075 Total $ 149,060 $ 147,187

Supplemental Financial Inform_2

Supplemental Financial Information (Tables)	3 Months Ended
	Mar. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Inventories	Inventories consisted of the following (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 80,054 $ 70,027 Work-in-process 18,500 15,508 Finished goods 43,899 43,844 $ 142,453 $ 129,379
Accrued Liabilities	Accrued liabilities and other consisted of the following (in thousands): March 31, 2023 December 31, 2022 Legal and other administrative costs $ 15,403 $ 8,653 Contract liabilities 11,718 10,226 Operating lease liabilities 9,992 9,379 Interest payable 8,379 (76) Research and development costs 7,667 7,020 Italian medical device payback law 6,960 6,414 Royalty accrual 3,816 3,950 Provisions for agents, returns and other 2,428 1,678 Current derivative liabilities 1,236 5,886 Restructuring liabilities 798 2,045 Other accrued expenses 27,956 26,306 $ 96,353 $ 81,481
Foreign Exchange and Other Gains (Losses)	The table below presents the items included within “Foreign exchange and other income/(expense)” on the condensed consolidated statements of income (in thousands): Three Months Ended March 31, 2023 2022 Exchangeable Notes fair value adjustment (1) $ 44,390 $ 11,040 Capped call fair value adjustment (1) (23,379) (9,912) Foreign exchange rate fluctuations 222 2,791 Interest income 4,536 20 Other (222) (35) Foreign exchange and other income/(expense) $ 25,547 $ 3,904 (1) Refer to “Note 3. Fair Value Measurements”
Schedule of Cash, Cash Equivalents and Restricted Cash	The table below presents a reconciliation of cash, cash equivalents and restricted cash reported on the condensed consolidated balance sheets that sum to the total of the amounts shown on the condensed consolidated statement of cash flows (in thousands): March 31, 2023 December 31, 2022 Cash and cash equivalents $ 214,340 $ 214,172 Restricted cash (1) 308,618 301,446 Cash, cash equivalents and restricted cash $ 522,958 $ 515,618 (1) Restricted cash represents funds held as collateral for the SNIA Litigation Guarantee. Refer to “Note 6. Commitments and Contingencies.”
Schedule of Cash, Cash Equivalents and Restricted Cash	The table below presents a reconciliation of cash, cash equivalents and restricted cash reported on the condensed consolidated balance sheets that sum to the total of the amounts shown on the condensed consolidated statement of cash flows (in thousands): March 31, 2023 December 31, 2022 Cash and cash equivalents $ 214,340 $ 214,172 Restricted cash (1) 308,618 301,446 Cash, cash equivalents and restricted cash $ 522,958 $ 515,618 (1) Restricted cash represents funds held as collateral for the SNIA Litigation Guarantee. Refer to “Note 6. Commitments and Contingencies.”

Unaudited Condensed Consolida_3

Unaudited Condensed Consolidated Financial Statements - Narrative (Details)	3 Months Ended
	Mar. 31, 2023
Revenue Benchmark | Geographic Concentration Risk | Russian Federation
Segment Reporting Information [Line Items]
Concentration risk, percentage	1%

Business Combinations - Narrati

Business Combinations - Narrative (Details) - USD ($) $ in Thousands		3 Months Ended
	May 02, 2022	Mar. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Cash to be paid at closing		$ 15,586
ALung Acquisition
Business Acquisition [Line Items]
Agreement to acquire equity interests	97%
Maximum consideration	$ 110,000
Cash to be paid at closing	10,000
Noncash consideration	5,500
Contingent consideration	$ 100,000
ALung Acquisition | ALung Acquisition
Business Acquisition [Line Items]
Ownership percentage			3%

Business Combinations - Fair Va

Business Combinations - Fair Value of Consideration Transferred (Details) - USD ($) $ in Thousands		3 Months Ended
	May 02, 2022	Mar. 31, 2023
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 Acquisition
Business Acquisition [Line Items]
Cash and other considerations	$ 10,000
ALung Acquisition | 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	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Goodwill	$ 774,447	$ 768,787
ALung Acquisition
Business Acquisition [Line Items]
Intangible assets	2,900
Goodwill	26,870
Other assets and liabilities, net	2,607
Net assets acquired	$ 32,377
Useful life	15 years
ALung Acquisition | Initial Fair Value of Consideration
Business Acquisition [Line Items]
Intangible assets	$ 13,950
Goodwill	25,893
Other assets and liabilities, net	2,112
Net assets acquired	41,955
ALung Acquisition | Measurement Period Adjustments
Business Acquisition [Line Items]
Intangible assets	(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	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	May 02, 2022 USD ($)
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Sales-based earnout	$ 90,119	$ 85,292
Level 3 | ALung Acquisition
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Sales-based earnout			$ 16,791
Measurement Input, Risk Free Interest Rate [Member] | Level 3 | Minimum | ALung Acquisition
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Sales-based earnout, measurement input			0.070
Measurement Input, Risk Free Interest Rate [Member] | Level 3 | Maximum | ALung Acquisition
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Sales-based earnout, measurement input			0.084
Measurement Input, Entity Credit Risk [Member] | Level 3 | Minimum | ALung Acquisition
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Sales-based earnout, measurement input			0.064
Measurement Input, Entity Credit Risk [Member] | Level 3 | Maximum | ALung Acquisition
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Sales-based earnout, measurement input			0.080
Measurement Input, Price Volatility [Member] | Level 3 | ALung Acquisition
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Sales-based earnout, measurement input			0.257

Fair Value Measurements - Asset

Fair Value Measurements - Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022
Liabilities:
Contingent consideration	$ 90,119	$ 85,292
Capped call derivatives
Assets:
Derivative asset	31,000		$ 54,400
Fair Value, Recurring
Assets:
Convertible notes receivable	275	285
Total assets	32,189	56,011
Liabilities:
Contingent consideration	90,119	85,292
Total liabilities	132,640	176,853
Fair Value, Recurring | Embedded exchange feature
Liabilities:
Derivative liabilities	41,285	85,675
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Liabilities:
Derivative liabilities	1,236
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments: | Capped call derivatives
Assets:
Derivative asset	31,014	54,393
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments: | Interest rate swap contracts
Assets:
Derivative asset	900
Fair Value, Recurring | Derivatives Designated as Hedging Instruments: | Interest rate swap contracts
Assets:
Derivative asset		1,333
Fair Value, Recurring | Derivatives Designated as Hedging Instruments: | Foreign Exchange Contract
Liabilities:
Derivative liabilities		5,886
Fair Value, Recurring | Level 1
Assets:
Convertible notes receivable	0	0
Total assets	0	0
Liabilities:
Contingent consideration	0	0
Total liabilities	0	0
Fair Value, Recurring | Level 1 | Embedded exchange feature
Liabilities:
Derivative liabilities	0	0
Fair Value, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Liabilities:
Derivative liabilities	0
Fair Value, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments: | Capped call derivatives
Assets:
Derivative asset	0	0
Fair Value, Recurring | Level 1 | Derivatives Designated as Hedging Instruments: | Interest rate swap contracts
Assets:
Derivative asset	0	0
Fair Value, Recurring | Level 1 | Derivatives Designated as Hedging Instruments: | Foreign Exchange Contract
Liabilities:
Derivative liabilities		0
Fair Value, Recurring | Level 2
Assets:
Convertible notes receivable	0	0
Total assets	900	1,333
Liabilities:
Contingent consideration	0	0
Total liabilities	1,236	5,886
Fair Value, Recurring | Level 2 | Embedded exchange feature
Liabilities:
Derivative liabilities	0	0
Fair Value, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Liabilities:
Derivative liabilities	1,236
Fair Value, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments: | Capped call derivatives
Assets:
Derivative asset	0	0
Fair Value, Recurring | Level 2 | Derivatives Designated as Hedging Instruments: | Interest rate swap contracts
Assets:
Derivative asset	900	1,333
Fair Value, Recurring | Level 2 | Derivatives Designated as Hedging Instruments: | Foreign Exchange Contract
Liabilities:
Derivative liabilities		5,886
Fair Value, Recurring | Level 3
Assets:
Convertible notes receivable	275	285
Total assets	31,289	54,678
Liabilities:
Contingent consideration	90,119	85,292
Total liabilities	131,404	170,967
Fair Value, Recurring | Level 3 | Embedded exchange feature
Liabilities:
Derivative liabilities	41,285	85,675
Fair Value, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Liabilities:
Derivative liabilities	0
Fair Value, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments: | Capped call derivatives
Assets:
Derivative asset	31,014	54,393
Fair Value, Recurring | Level 3 | Derivatives Designated as Hedging Instruments: | Interest rate swap contracts
Assets:
Derivative asset	$ 0	0
Fair Value, Recurring | Level 3 | Derivatives Designated as Hedging Instruments: | Foreign Exchange Contract
Liabilities:
Derivative liabilities		$ 0

Fair Value Measurements - Recon

Fair Value Measurements - Reconciliation of Recurring Fair Value Measurements (Details) - Fair Value, Recurring - Level 3 $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($)
Liabilities Measured on Recurring Basis
Total at beginning period	$ 85,292
Total at period end	90,119
Embedded Exchange Feature Derivative Liability
Liabilities Measured on Recurring Basis
Total at beginning period	85,675
Changes in fair value	(44,390)
Total at period end	41,285
Contingent Consideration Liability Arrangements
Liabilities Measured on Recurring Basis
Total at beginning period	85,292
Changes in fair value	4,827
Total at period end	90,119
Capped Call Derivative Asset
Assets Measured on Recurring Basis
As of beginning period	54,393
Changes in fair value	(23,379)
Total at period end	31,014
Convertible Notes Receivable
Assets Measured on Recurring Basis
As of beginning period	285
Changes in fair value	(10)
Total at period end	$ 275

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details)	Mar. 31, 2023 USD ($)	Mar. 31, 2022 USD ($)	Jun. 30, 2020 USD ($)	Jun. 17, 2020 USD ($)
Embedded exchange feature
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
10 percent decrease in stock price volatility, fair value	$ 13,500,000
10 percent increase in stock price volatility, fair value	12,900,000
Capped call derivatives
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative asset	31,000,000	$ 54,400,000
10 percent decrease in stock price volatility, fair value	8,600,000
10 percent increase in stock price volatility, fair value	$ 4,500,000
Measurement Input, Stock Price Volatility | Embedded exchange feature
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability, measurement input	0.40
Measurement Input, Stock Price Volatility | Capped call derivatives
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability, measurement input	0.40
Senior Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount				$ 287,500,000
Fair value of embedded derivative liability	$ 41,300,000	$ 85,700,000
2020 Cash Exchangeable Senior Notes | Senior Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount			$ 287,500,000

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Contingent Consideration by Acquisition (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	May 02, 2022
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 90,119	$ 85,292
Fair Value, Recurring
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	90,119	85,292
Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	90,119	85,292
Total fair value of Level 3 contingent consideration arrangements	90,119	85,292
ImThera | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	73,056	69,389
ALung Acquisition | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration			$ 16,791
ALung Acquisition | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 17,063	$ 15,903

Fair Value Measurements - Signi

Fair Value Measurements - Significant Unobservable Inputs (Details) - Level 3	Mar. 31, 2023
ImThera | Discounted cash flow | Discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.097
ImThera | Discounted cash flow | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
ImThera | Monte Carlo simulation | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
ImThera | Monte Carlo simulation | Revenue volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.325
ImThera | Minimum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.138
ImThera | Minimum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.100
ImThera | Maximum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.141
ImThera | Maximum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.106
ALung Acquisition | Monte Carlo simulation | Revenue volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.307
ALung Acquisition | Minimum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.093
ALung Acquisition | Minimum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.091
ALung Acquisition | Maximum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.104
ALung Acquisition | Maximum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.102

Financing Arrangements - Schedu

Financing Arrangements - Schedule of Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	Jun. 17, 2020
Debt Instrument [Line Items]
Total long-term facilities	$ 541,758	$ 538,959
Less current portion of long-term debt	21,557	20,892
Total long-term debt obligations	$ 520,201	518,067
Bank of America Merrill Lynch Banco Múltiplo S.A.
Debt Instrument [Line Items]
Interest rate, stated percentage	16.20%
Mediocredito Italiano | Minimum
Debt Instrument [Line Items]
Interest rate, stated percentage	0.50%
Mediocredito Italiano | Maximum
Debt Instrument [Line Items]
Interest rate, stated percentage	6.59%
Bank of America, U.S.
Debt Instrument [Line Items]
Interest rate, stated percentage	7.74%
Term Loan
Debt Instrument [Line Items]
Total long-term facilities	$ 288,022	289,294
Interest rate, stated percentage	8.20%
Senior Notes
Debt Instrument [Line Items]
Total long-term facilities	$ 243,320	239,568
Interest rate, stated percentage	3%		3%
Loans Payable | Bank of America Merrill Lynch Banco Múltiplo S.A.
Debt Instrument [Line Items]
Total long-term facilities	$ 6,715	6,462
Loans Payable | Mediocredito Italiano
Debt Instrument [Line Items]
Total long-term facilities	1,637	1,601
Loans Payable | Bank of America, U.S.
Debt Instrument [Line Items]
Total long-term facilities	1,500	1,500
Other
Debt Instrument [Line Items]
Total long-term facilities	$ 564	$ 534

Financing Arrangements - Narrat

Financing Arrangements - Narrative (Details) $ / shares in Units, € in Millions			3 Months Ended		12 Months Ended
	Jul. 06, 2022 USD ($)	Jun. 17, 2020 USD ($)	Mar. 31, 2023 USD ($) claim $ / shares	Mar. 31, 2022 USD ($)	Dec. 31, 2022 USD ($)	Mar. 31, 2023 £ / 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			$ 308,618,000		$ 301,446,000
Amortization of debt issuance costs			5,019,000	$ 4,412,000
Proceeds from long-term debt obligations			$ 0	218,342,000
Capped call derivatives
Debt Instrument [Line Items]
Derivative, cap price per share | $ / shares			$ 100
Derivative asset			$ 31,000,000	54,400,000
Bridge Loan | SNIA | Judicial Ruling
Debt Instrument [Line Items]
Percentage of cash collateral required as guarantee							105%
Senior Notes
Debt Instrument [Line Items]
Interest rate			9.95%
Debt discounts and issuance costs		$ 82,000,000
Amortization of debt issuance costs			$ 3,800,000	3,400,000
Unamortized discount (premium), net			$ 44,200,000		47,900,000
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 | £ / 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 | $ / shares			$ 60.98
Redemption price, percentage			100%
Fair value of embedded derivative liability			$ 41,300,000	$ 85,700,000
Conversion ratio			0.016398
Revolving Credit Facility
Debt Instrument [Line Items]
Short-term debt			$ 700,000		$ 2,500,000
Line of credit, maximum borrowing capacity											$ 125,000,000
Commitment fee percentage					0.50%
Borrowed funds			$ 0		$ 0
Revolving Credit Facility | Initial Term Facility
Debt Instrument [Line Items]
Interest rate			6.53%
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			$ 900,000
Revolving Credit Facility | Bridge Loan | Goldman Sachs Bank USA
Debt Instrument [Line Items]
Line of credit, maximum borrowing capacity								$ 220,000,000		€ 200
Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Debt instrument, term	5 years
Line of credit, maximum borrowing capacity	$ 350,000,000
Commitment fee percentage	0.50%
Debt discounts and issuance costs			9,600,000
Amortization of debt issuance costs			500,000
Unamortized discount (premium), net			8,200,000
Days to maturity	91 days
Discount rate	1.50%
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, maximum borrowing capacity	$ 300,000,000
Revolving Credit Facility | Line of Credit | Delayed Draw Term Facility
Debt Instrument [Line Items]
Line of credit, 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			$ 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 | Maximum
Debt Instrument [Line Items]
Interest rate			4.24%
Debt instrument, term			364 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) - Foreign Exchange Contract - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Derivative [Line Items]
Gain (loss) on derivative	$ (1.3)	$ 1
Derivatives Not Designated as Hedging Instruments:
Derivative [Line Items]
Notional amount	$ 128		$ 154.5

Derivatives and Risk Manageme_4

Derivatives and Risk Management - Derivative Notional Amounts (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Derivatives Designated as Hedging Instruments: | Cash Flow Hedging | Interest rate swap contracts
Derivative [Line Items]
Notional amount	$ 210,000	$ 210,000

Derivatives and Risk Manageme_5

Derivatives and Risk Management - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - Cash Flow Hedging - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Derivative Instruments, Gain (Loss) [Line Items]
(Losses) Gains Recognized in OCI	$ (433)	$ (642)
(Losses) Gains Reclassified from AOCI to Earnings	533	53
Foreign Exchange Contract | Foreign exchange and other income/(expense)
Derivative Instruments, Gain (Loss) [Line Items]
(Losses) Gains Recognized in OCI	0	(642)
(Losses) Gains Reclassified from AOCI to Earnings	0	441
Foreign Exchange Contract | SG&A
Derivative Instruments, Gain (Loss) [Line Items]
(Losses) Gains Recognized in OCI	0	0
(Losses) Gains Reclassified from AOCI to Earnings	0	(388)
Derivatives Designated as Hedging Instruments: | Interest rate swap contracts | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
(Losses) Gains Recognized in OCI	(433)	0
(Losses) Gains Reclassified from AOCI to Earnings	$ 533	$ 0

Derivatives and Risk Manageme_6

Derivatives and Risk Management - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Derivatives, Fair Value [Line Items]
Total asset derivatives	$ 31,914	$ 55,726
Total liability derivatives	42,521	91,561
Derivatives Designated as Hedging Instruments:
Derivatives, Fair Value [Line Items]
Total asset derivatives	900	1,333
Derivatives Designated as Hedging Instruments: | Prepaid expenses and other current assets | Interest rate swap contracts
Derivatives, Fair Value [Line Items]
Total asset derivatives	900	1,333
Derivatives Not Designated as Hedging Instruments:
Derivatives, Fair Value [Line Items]
Total asset derivatives	31,014	54,393
Total liability derivatives	42,521	91,561
Derivatives Not Designated as Hedging Instruments: | Accrued liabilities and other | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total liability derivatives	1,236	5,886
Derivatives Not Designated as Hedging Instruments: | Long-term derivative assets | Capped call derivatives
Derivatives, Fair Value [Line Items]
Total asset derivatives	31,014	54,393
Derivatives Not Designated as Hedging Instruments: | Long-term derivative liabilities | Embedded exchange feature
Derivatives, Fair Value [Line Items]
Total liability derivatives	$ 41,285	$ 85,675

Commitments and Contingencies -

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

1 Months Ended

3 Months Ended

12 Months Ended

May 03, 2023 claim

Jul. 29, 2022 EUR (€)

Feb. 21, 2022 EUR (€)

Mar. 29, 2019 USD ($)

Apr. 01, 2016 EUR (€)

Jan. 31, 2021 EUR (€) repository_site

Jan. 31, 2020 USD ($)

Mar. 31, 2023 EUR (€)

Mar. 31, 2023 USD ($)

Dec. 31, 2022 EUR (€)

Dec. 31, 2022 USD ($)

Apr. 30, 2022 EUR (€)

Nov. 30, 2021 EUR (€)

Mar. 05, 2019 EUR (€)

Other Commitments [Line Items]

Reimbursed legal fees

€ 292

$ 318,062

Environmental maintenance | €

€ 1,000

Heart Valves

Other Commitments [Line Items]

Warranty, cap on claims

€ 8,000

8,700

Subsequent Event

Other Commitments [Line Items]

Pending claims, number | claim

85

Number of settled claims | claim

4

Mitral | Heart Valves

Other Commitments [Line Items]

Compensation sought

€ 20,800

22,700

Pending Litigation

Other Commitments [Line Items]

Estimate of possible loss

623,200

€ 572,100

Saluggia, Italy

Other Commitments [Line Items]

Number of national repository sites | repository_site

67

Estimated provision

€ 34,100

37,100

Estimated liability

€ 34,200

$ 36,600

Saluggia, Italy | Minimum

Other Commitments [Line Items]

Estimated provision

34,100

37,100

Saluggia, Italy | Maximum

Other Commitments [Line Items]

Estimated provision

€ 43,500

47,300

Product Liability

Other Commitments [Line Items]

Litigation settlement, amount awarded to other party

$ 225,000

Litigation provision liability

22,370

32,487

First demand bank guarantee

11,568

Product Liability | Second Payment

Other Commitments [Line Items]

Payments for legal settlements

$ 90,000

SNIA | Pending Litigation | SNIA s.p.a

Other Commitments [Line Items]

Compensation sought

3,700,000

Non-privileged creditor, amount | €

€ 454,000

SNIA | Judicial Ruling

Other Commitments [Line Items]

Estimate of possible loss

494,100

€ 453,600

SNIA | Judicial Ruling | Surety Bond

Other Commitments [Line Items]

First demand bank guarantee

€ 270,000

294,100

Italian MedTech Payback | Pending Litigation

Other Commitments [Line Items]

Estimate of possible loss

$ 7,000

$ 6,400

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Product Liability (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($)
Loss Contingency Accrual [Roll Forward]
Less current portion of litigation liability at period end	$ 19,311
Long-term portion of litigation provisions liability at period end	3,059
Product Liability
Loss Contingency Accrual [Roll Forward]
Total litigation provision liability at beginning of period	32,487
Payments	(11,568)
Adjustments	1,314
FX and other	137
Total litigation provision liability at end of period	$ 22,370

Stockholders' Equity - Statemen

Stockholders' Equity - Statement of Stockholders' Equity (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)	53,851,979
Beginning balance	$ 1,207,624	$ 1,294,645
Stock-based compensation plans	5,260	3,171
Net income	7,370	2,993
Other comprehensive income (loss)	$ 7,087	(8,955)
Ending balance (in shares)	53,854,241
Ending balance	$ 1,227,341	$ 1,291,854
Ordinary Shares
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)	53,852,000	53,762,000
Beginning balance	$ 82,424	$ 82,295
Stock-based compensation plans (in shares)	2,000	2,000
Stock-based compensation plans	$ 0	$ 3
Ending balance (in shares)	53,854,000	53,764,000
Ending balance	$ 82,424	$ 82,298
Additional Paid-In Capital
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	2,157,724	2,117,961
Stock-based compensation plans	5,204	3,137
Ending balance	2,162,928	2,121,098
Treasury Stock
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(375)	(650)
Stock-based compensation plans	56	31
Ending balance	(319)	(619)
Accumulated Other Comprehensive (Loss) Income
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(48,119)	(7,177)
Other comprehensive income (loss)	7,087	(8,955)
Ending balance	(41,032)	(16,132)
Accumulated Deficit
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(984,030)	(897,784)
Net income	7,370	2,993
Ending balance	$ (976,660)	$ (894,791)

Stockholders' Equity - Comprehe

Stockholders' Equity - Comprehensive Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	$ 1,207,624	$ 1,294,645
Other comprehensive loss before reclassifications, before tax	7,620	(8,902)
Tax benefit	0	0
Other comprehensive loss before reclassifications, net of tax	7,620	(8,902)
Reclassification of loss from accumulated other comprehensive income, before tax	(533)	(53)
Reclassification of tax benefit	0	0
Reclassification of gain from accumulated other comprehensive loss, after tax	(533)	(53)
Total other comprehensive income (loss)	7,087	(8,955)
Ending balance	1,227,341	1,291,854
Total
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(48,119)	(7,177)
Total other comprehensive income (loss)	7,087	(8,955)
Ending balance	(41,032)	(16,132)
Change in Unrealized Gain (Loss) on Derivatives
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	966	(945)
Other comprehensive loss before reclassifications, before tax	(433)	(642)
Tax benefit	0	0
Other comprehensive loss before reclassifications, net of tax	(433)	(642)
Reclassification of loss from accumulated other comprehensive income, before tax	(533)	(53)
Reclassification of tax benefit	0	0
Reclassification of gain from accumulated other comprehensive loss, after tax	(533)	(53)
Total other comprehensive income (loss)	(966)	(695)
Ending balance	0	(1,640)
Foreign Currency Translation Adjustments Gain (Loss)
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(49,085)	(6,232)
Other comprehensive loss before reclassifications, before tax	8,053	(8,260)
Tax benefit	0	0
Other comprehensive loss before reclassifications, net of tax	8,053	(8,260)
Reclassification of loss from accumulated other comprehensive income, before tax	0	0
Reclassification of tax benefit	0	0
Reclassification of gain from accumulated other comprehensive loss, after tax	0	0
Total other comprehensive income (loss)	8,053	(8,260)
Ending balance	$ (41,032)	$ (14,492)

Stock-Based Incentive Plans - N

Stock-Based Incentive Plans - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2023 USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement, vesting period	4 years
Share-based compensation arrangement, compensation cost	$ 0.1
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement, vesting period	3 years
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement, vesting period	3 years

Stock-Based Incentive Plans - C

Stock-Based Incentive Plans - Compensation Expense (Details) - Continuing Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 10,579	$ 10,256
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	5,717	5,344
SARs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	3,121	2,938
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	881	851
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	570	785
Employee share purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 290	$ 338

Stock-Based Incentive Plans - E

Stock-Based Incentive Plans - Executed Agreements (Details) shares in Thousands	3 Months Ended
	Mar. 31, 2023 $ / shares shares
SARs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	974,204
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 19.44
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	459,818
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 42.30
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	94,561
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 38.95
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	94,556
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 42.30

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Effective tax rate (percent)	24.30%	45.60%
Unrecognized tax benefits	$ 1.7		$ 1.6
Unrecognized tax benefits, potential decrease amount	$ 1

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Basic weighted average shares outstanding (in shares)	53,617	53,300
Add effects of share-based compensation instruments (in shares)	283	876
Diluted weighted average shares outstanding (in shares)	53,900	54,176

Earnings Per Share - Narrative

Earnings Per Share - Narrative (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Stock Compensation Plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share amount (in shares)	3.2	2.2

Geographic and Segment Inform_3

Geographic and Segment Information - Narrative (Details)	3 Months Ended
	Mar. 31, 2023 geographic_region segment
Segment Reporting [Abstract]
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 & Geographic Region (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Net revenue	$ 263,418	$ 240,175
Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	132,072	117,075
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	120,723	110,227
Operating Segments | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	9,842	11,683
Other
Segment Reporting Information [Line Items]
Net revenue	781	1,190
United States
Segment Reporting Information [Line Items]
Net revenue	140,267	136,269
United States | Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	36,114	38,096
United States | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	94,489	87,210
United States | Operating Segments | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	9,664	10,963
United States | Other
Segment Reporting Information [Line Items]
Net revenue	0	0
Europe
Segment Reporting Information [Line Items]
Net revenue	49,643	45,126
Europe | Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	36,283	32,067
Europe | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	13,280	12,456
Europe | Operating Segments | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	80	603
Europe | Other
Segment Reporting Information [Line Items]
Net revenue	0	0
Rest of World
Segment Reporting Information [Line Items]
Net revenue	73,508	58,780
Rest of World | Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	59,675	46,912
Rest of World | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	12,954	10,561
Rest of World | Operating Segments | Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net revenue	98	117
Rest of World | Other
Segment Reporting Information [Line Items]
Net revenue	$ 781	$ 1,190

Geographic and Segment Inform_5

Geographic and Segment Information - Reconciliation of Segment (Loss) Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Operating (loss) income	$ (2,342)	$ 9,505
Interest expense	(13,437)	(7,840)
Foreign exchange and other income/(expense)	25,547	3,904
Income before tax	9,768	5,569
Continuing Operations
Segment Reporting Information [Line Items]
Total reportable segment income	5,009	15,853
Other expenses	7,351	6,348
Operating (loss) income	(2,342)	9,505
Operating Segments | Cardiopulmonary | Continuing Operations
Segment Reporting Information [Line Items]
Total reportable segment income	7,584	6,895
Operating Segments | Neuromodulation | Continuing Operations
Segment Reporting Information [Line Items]
Total reportable segment income	27,006	37,478
Operating Segments | Advanced Circulatory Support | Continuing Operations
Segment Reporting Information [Line Items]
Total reportable segment income	(6,449)	(5,438)
Other | Continuing Operations
Segment Reporting Information [Line Items]
Total reportable segment income	$ (23,132)	$ (23,082)

Geographic and Segment Inform_6

Geographic and Segment Information - Assets & Expenditures by Segments (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Segment Reporting Information [Line Items]
Assets	$ 2,294,888		$ 2,294,773
Continuing Operations
Segment Reporting Information [Line Items]
Capital expenditures	7,851	$ 5,580
Operating Segments | Cardiopulmonary | Continuing Operations
Segment Reporting Information [Line Items]
Assets	885,784		874,143
Capital expenditures	4,798	1,829
Operating Segments | Neuromodulation | Continuing Operations
Segment Reporting Information [Line Items]
Assets	642,467		646,633
Capital expenditures	359	84
Operating Segments | Advanced Circulatory Support | Continuing Operations
Segment Reporting Information [Line Items]
Assets	118,120		121,454
Capital expenditures	137	684
Other | Continuing Operations
Segment Reporting Information [Line Items]
Assets	648,517		$ 652,543
Capital expenditures	$ 2,557	$ 2,983

Geographic and Segment Inform_7

Geographic and Segment Information - Changes in Carrying Amount of Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($)
Goodwill
Goodwill, beginning	$ 768,787
Foreign currency adjustments	5,660
Goodwill, ending	774,447
Cardiopulmonary
Goodwill
Goodwill, beginning	370,033
Foreign currency adjustments	5,660
Goodwill, ending	375,693
Neuromodulation
Goodwill
Goodwill, beginning	398,754
Foreign currency adjustments	0
Goodwill, ending	$ 398,754

Geographic and Segment Inform_8

Geographic and Segment Information - Geographic Areas (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 149,060	$ 147,187
United States
Segment Reporting Information [Line Items]
Property, plant and equipment, net	65,058	63,458
Europe
Segment Reporting Information [Line Items]
Property, plant and equipment, net	79,797	79,654
Rest of World
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 4,205	$ 4,075

Supplemental Financial Inform_3

Supplemental Financial Information - Inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Raw materials	$ 80,054	$ 70,027
Work-in-process	18,500	15,508
Finished goods	43,899	43,844
Inventory, Net	$ 142,453	$ 129,379

Supplemental Financial Inform_4

Supplemental Financial Information - Narrative (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Provision for obsolescence	$ 10	$ 8.2
Contract liability	$ 15.5	$ 14.1

Supplemental Financial Inform_5

Supplemental Financial Information - Accrued Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Legal and other administrative costs	$ 15,403	$ 8,653
Contract liabilities	11,718	10,226
Operating lease liabilities	9,992	9,379
Interest payable	8,379	(76)
Research and development costs	7,667	7,020
Italian medical device payback law	6,960	6,414
Royalty accrual	3,816	3,950
Provisions for agents, returns and other	2,428	1,678
Current derivative liabilities	1,236	5,886
Restructuring liabilities	798	2,045
Other accrued expenses	27,956	26,306
Accrued liabilities and other	$ 96,353	$ 81,481

Supplemental Financial Inform_6

Supplemental Financial Information - Foreign Exchange (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Debt Instrument [Line Items]
Foreign exchange rate fluctuations	$ 222	$ 2,791
Interest income	4,536	20
Other	(222)	(35)
Foreign exchange and other income/(expense)	25,547	3,904
Senior Notes | Embedded Exchange Feature Derivative Liability
Debt Instrument [Line Items]
Changes in fair value	44,390	11,040
Capped call derivatives | Capped Call Derivative Asset
Debt Instrument [Line Items]
Changes in fair value	$ (23,379)	$ (9,912)

Supplemental Financial Inform_7

Supplemental Financial Information - Cash, Cash Equivalents, Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Receivables [Abstract]
Cash and cash equivalents	$ 214,340	$ 214,172
Restricted cash	308,618	301,446
Cash, cash equivalents and restricted cash	$ 522,958	$ 515,618	$ 442,384	$ 207,992

Subsequent Events (Details)

Subsequent Events (Details) $ in Millions	Apr. 06, 2023 USD ($)
Subsequent Event | Delayed Draw Term Facility | Revolving Credit Facility | Line of Credit
Subsequent Event [Line Items]
Proceeds from line of credit	$ 50