Edwards Lifesciences (EW) 24 Jul 242024 Q2 Earnings call transcript

Greetings, and welcome to the Edwards Lifesciences Second Quarter 2024 Results. [Operator Instructions] As a reminder, this conference is being recorded. It's now my pleasure to introduce your host, Mark Wilterding, Senior Vice President, Investor Relations. Thank you.

You may begin.

Thank you very much, Kevin. you joining thank and afternoon, all us. for Good is Bernard Zovighian; me on our CEO, call today's Ullem. With and our CFO, Scott us Heart; Heart; Szyman, of Markowitz, Daveen our portion and Q&A our global Larry Katie President for Leader TMTT; call Care. Chopra, TAVR Critical joining Wayne of of Structural be Global Wood, Leader of of Surgical our and Global Global leader will our Also the the Surgical Structural

second of regular financial trading, Just quarter after released XXXX Lifesciences the close results. Edwards

the During management the discuss expectations These then limited not results press statements after and clinical based approvals, for foreign will litigation, guidance those and release remaining are leverage today. growth speak financial estimates, and to, that does update management Q&A. Please are on the strategy, not These today's statements include, schedules acquisitions, any only be assumptions on will but call, currency for statements integration projections. included making obligation note matters them undertake regulatory that of of are to and made, and in accompanying reimbursements, date and use fluctuations. forward-looking which time financial Edwards competitive they and trials, opportunities as

found I'd quarterly available between XX-K that on of all on and included to the Bernard during call Additionally, turn could comments. which report call Information sales be to other for refers growth earlier results concerning non-GAAP numbers that, his to company's safety today. press is the are statements cause like also Reconciliations noted, currency important annual GAAP otherwise edwards.com. Unless sales issued on are the defined could release. With the factors release, in Edwards' website XXXX Form these release commentary risks press over the growth, in mentioned in the the and press at our to SEC involve can which uncertainties information that actual our cause differ materially. and differences company's filings, and constant

two which and in Thank the press and releases, you, team you us. Mark, now. joining all with review for issued should you will we thank more detail afternoon, This I

our aortic of transcatheter the AR; a failure QX X% or a $X.X our and increased highlighting the of quarter leader will sales treatment constant basis pioneer currency the second JenaValve, results. management period. outlining first billion, in regurgitation, in start The Endotronix, year second, I acquisition performance. Total solutions. with ago our on a And company versus heart of

important our contribution employees the second product growth research, of made we by many needs addition, expected, yet the with in Edwards more unmet increasingly to significant address clinical pleased patients the we than was advancements from lower in new In and around quarter are the efforts TMTT. introductions TAVR world.

a has into Our growth TMTT strategic reality, of a Edwards is technology. deliver vision for well commitment remains and developed Overall, our sustainable positioned growth. to portfolio differentiated becoming strong

this acquisitions, JenaValve two announced also We afternoon and Endotronix.

ongoing with these have known many acquisitions earnings. years. been for timing the We these of with companies some for have time the coincided Discussions and company

failure, heart two the around are for heart and innovation with science therapeutic technologies leverage capabilities We to world. ensure new access to world-class expand patients and evidence AR we and to structural into accelerated pleased will life-saving areas, our clinical

Edward's product X% although change year-over-year, will on increased growth. In additional meaningfully than not globally, position I results global some billion lower experienced and pressure maintain regional pricing. $X.XX detail QX competitive sales Now some by we planned. second provide of did TAVR, we quarter we

X meeting presented years trials, annuli. the which outcome PARTNER the deep from London. value the in to also additional is the and We high-quality New body we presented RHEIA platform, clinical demonstrated technology, AS evidence patients. At commitment RHEIA data to study additional meeting on in upcoming anticipate with continue evidence Adding at analyses to are on the York of system. in care XXX clinicians to of remain sites XX for the than patients global we women and ESC patients randomized small excellent across demonstrate aortic safety patients to the focused advancing health be differentiated and stenosis. our confident Valve severe the surgery from comparing and Europe, We up we our June, the versus study in TAVR prospective a symptomatic to in evidence with women more efficacy in in continuing

believe the be opportunity global TAVR care our TAVR how We it presented sales through slightly to patient and was growth if TAVR rate. unchanged. timing prior competitive could over continue have and quarter proud are growth this meaningful could will year-over-year aortic largely are at believe to patients are the and results AS U.S. We stenosis AS on science while grow all year. deep for And the below a for also data constant impact compelling, we TAVR treatment, was significant our the patient patients. In which to our early the trials, TCT long for advancing U.S., globally actively second streamlining referral our currency change treated. progress pursuing patient are position term severe commitment fundamentally Early

workflows, expansion heart these of U.S. in Second impacted therapies, in other and the on These newly and they therapies therapies heart The structural put approved of fast-growing reflected were grew hospital quarter pressure part data stabilize. standard recent this their TAVR. growth slower sales we which adopt processes, centers observed become claims spike structural than also TAVR tricuspid will continued in emergent TAVR new as expected. including therapies, expect as pressures cases and

know scale currently demonstrate over in-system the treatment AS severe growth believe We to of to have time. We that ability persist demonstrated significant procedure hospital transcatheter number large evidence under go historically of experience untreated. support a from that patients

severe program to insights system aortic to activation to program which already care treatment the quarter, patient comprehensive We patients from are of hospital growth stenosis sales the identification, rates the TAVR constant for bring focused referrals patients. the U.S. Japan, slightly we a launched AI Edwards' growth sales improve world-class and real-time leverage the growth. is X of treatment stenosis. We our double-digit and streamlining and currency second TAVR suffering generated of improve within and aortic This our above by program the on severe are support efforts In quality RESILIA. ENACT was our cardiovascular Ultra TAVR In accelerating in system. Outside first-of-its-kind patients evaluation hospital global who the for symptomatic driven recently SAPIEN platform

slightly ability focus were and share pleased while AS with continue we on an annualized basis, SAPIEN to in population expanding under the elderly launch down momentum a We Europe, by the the Ultra substantial significant this believe of among remains treated Japan. In disease therapy driven X the of on is RESILIA.

patient outcome. are with procedure rates and success We high exceptional pleased

our momentum growth first half continue year-over-year growth to anticipate is health for have to bring volume similar care rate tremendous scaling continue more will for and activation patient Edwards We first-choice positioned new the full TAVR to billion global full differentiated rate, centers We expect management. In X% with evidence to to of XX%. deep as the to indications year the second to experienced high-quality of to This of growth healthy valves and year sales $X.X confident to TAVR for which procedures, in by driven initiative. and investment guidance that build motivated versus billion. our sustainable and $X patients equates TAVR system. growth our half clinical portfolio, commitment value zinc transcatheter the we previously sales We now TAVR closing, patient care remain increased believe X% accommodate are X% to to hospitals advancing lifetime

to Turning TMTT.

replacement our advance structural including technology, heart to mitral the tricuspid of deep and Our expertise SAPIEN enabled significantly the Repair the portfolio replacement MX System, us PASCAL has system EVOQUE system. differentiated

unmet for disease. is patients with of the addressing pipeline exciting tricuspid mitral needs large Our innovation and

and were we positive results led QX, prior XX% Europe. commercial to In market believe globally, PASCAL and to year. value adoption patients. versus of mitral and growing, the both physicians the early representing U.S. and premium the QX digit with introduction the Europe. differentiation is We sales double U.S. by brings its of it $XX grow in PASCAL increase tier in continues the achieved EVOQUE million, a reflecting and sales

bring continues EVOQUE this patients. The are therapy more to more more launch and to progress physicians We well. commercial to excited geographies,

is on required patient to outstanding a in outcome investing tricuspid focused resources successful centers, Our program. grow disciplined strategy

with opening are now in clinical new trial started We centers, our sites. both having U.S. the Europe after and

continue We population which this interest in strong the patients of options reflects for therapy, to few need unmet see the in have treatment. who significant

coverage finalize those our move transcatheter transcatheter of and Last TRISCEND world. opening trial. status, with Our month, early is of remains believe II the full valve in tricuspid has granted parallel coverage. SAPIEN TRISCEND II forward national around analysis EVOQUE replacement. Conference process, CMS can TCT get the launch breakthrough to and first valve to cohort review CMS data We to clinical we was demonstrated track on FDA from consistent at national excellent the experience Since the to therapy the October. the for real-world regulatory be approval utilizing replacement presenting results, CMS MX mitral announced quickly commercial look

the received the Innovalve enhance XXXX. Earlier designation sustainable and expertise our calcification the arm and we mitral completed further this than heart address in with also needs follow pipeline the million Heart, and Innovalve TMTT or both early-stage confident global second Edwards to options global for by TMTT our for and MX broader strong sustainable we month, therapies. In company that driven acquisition first year. Surgical will tricuspid our Innovalve. technology are in the We differentiated the will year year. on prior disease to million our annulus KONECT. growth this a for of to MAC this patient of expect advancement the technology, of half CE FDA adoption to enrollment acquisition growing expected SAPIEN quarter driven mid-XXXX, repair previous the we of positioned ongoing $XXX surgical technology, full sales replacement disease to Growth innovative long-term strong therapies a TMVR us INSPIRIS, and growth. Based over pleased receive expect close premium unique in adoption increasing million of to of innovative are will to earlier PASCAL expect has that higher announced range. XXXX unmet of $XXX technologies later Structural TMTT, we EVOQUE, portfolio remain to mitral now portfolio study. and in of to We add approval Edward's was support long-term mitral momentum set guidance many breakthrough We with previously ENCIRCLE large therapy clinicians structural have of Mark our in over from and offer the increased FDA combined and underserved We end growing a $XXX technologies with of the by X% sales treat strategy by complex strategy MITRIS The years, patients. the needed U.S.

treated the We see growth globally undergoing best continue to procedures. for many positive those complex including surgically procedure patients

Europe year. expand MITRIS adoption X% were the mitral prior in continue growth trial using Critical in the quarter that our surgical U.S. RESILIA IQ sensor. $XXX was our completed heart a be led full We granted also second we than Care, technologies, by for studying is ICU increased our sales device from the performance ramping enrollment of catheters. RESILIA the for for and in strong and Canada Acumen including million with Swan-Ganz was earlier in to we Growth overall devices pleased continued to by expected. body monitoring recovery In Demand overall portfolio which pressure have year surgeries. In X% strong versus evidence have to valve of France momentous XXXX driven reimbursement will and our critical been the X% smart confident are and the in contribution position. adoption sales summary, up, the RESILIA remain

thank in significant recovery all on QX. of dedication. which we Becton progress, smart their to June, focused smart announcing to and them has more late to expansion patients driving for Care the want family their home close to designed make are remains team work and help made by Critical sales to hard and growth and clinicians I get informed decisions Dickinson plan Since through care critical our of faster.

Edwards acquisitions failure long-term growth. and advancing of These the around areas our down opportunity approved U.S. more world. our transcatheter Heart Turning AR. Endotronix. new AR, the will untreated in access. System of in first unmet heart strategy for JenaValve, address an in the disease Valve treatment will therapeutic development anticipate JenaValve in XXXX, to is novel unique suffering strategic to and enable needs a and deep XXX,XXX patient Trilogy expanded the the commitment today. acquisition patients largely JenaValve deadly that this to late to patients patients accelerate earlier AR U.S. of the FDA of our alone to the confidence care sustainable of invest a technology patient with impacts and Furthermore, in than reflects reinforce through Edwards from therapy Edwards acquisition which Starting pioneer approval provide represent

this the treatment. in we believe valve valve aortic lead positioned of pioneers next to As disease innovation, are we best frontier

this be expect to beginning TAVR. long-term similar We iterative a the of to strategy

Turning to first XXXX. Endotronix. the in made Edwards in investment its company

the believe Heart from employees, This the we large will suffering are with significant limited a failure, a suffer a serve we many into with technology, area the which So Structural structural unmet heart long-term Edwards very failure today portfolio opportunity has patients Edwards address patients of therapeutic familiar also heart options. opportunity. new from the growth needs and expand to heart acquisition

received for pulmonary indicator artery congestion, the leading approval publication sensor an Cordella, U.S. directly month, implantable successful that trial. measure Last FDA following Endotronix of the the of pressure pivotal

to Endotronix We technologies are contribution enter will this to world. structural for is science strengthen revenue the the patients leadership and structural provide evidence to and XXXX. innovation We access with begin opportunities. life-saving JenaValve late expected long-term in investment innovation, its therapeutic represent and anticipate growth in world-class heart from area heart clinical Minimal to around pleased

now a and turn new tell, I many positive with across can and population. And the to lot to our momentum you will combined As we call of reach businesses, have TAVR, patient opportunities Scott. over core TMTT Surgical, catalysts

not Thanks Bernard. we where were performance lot [indiscernible] obviously, company came a sales growth sales ] So in below quarter satisfied [ expectations. total TAVR our

is pleased we our continues to However, TMTT was growth, And care, of nearly was to GAAP release. critical $X.XX included today's of per onetime it's underlying EPS adjusted overall sale important were per A outperform Care. $X.XX. the included related adjusted and full earnings expenses between broader context, earnings X%, to share GAAP including understand share reconciliation that separation sales Critical our expectations. with

of discontinued file which will presented the Care next details we Note additional including Critical cover as Care. reflects Critical will operation I'll our week. now company in be So P&L, XX-Q results, total that a

provide third As we we Critical reflecting announced noted quarter results. information in XXXX we'll the press of the acquisitions this release, and Care report QX the sale when month

year. gross adjusted same benefited the For to margin was quarter a the favorable second Last gross margin rates. in second foreign year's XX.X% impact quarter, more from profit compared our profit XX.X% exchange period last from

was care by prior XX% investments primarily in sales including yield to million EVOQUE. We expect driven Edwards was of including quarter be PASCAL QX the or This adjusted gross This QX, the general profit the margin, personnel the $XXX with transcatheter margins. in over XX.X% valve $XXX increase of technologies and that field-based an million, in million our XX.X% in growth administrative and expenses development compared were strong the profit expenses quarter therapies including clinical to selling, or by sales. second of prior and result high-value critical gross year. and of support grew driven increase expansion line Adjusted rollout to continued activity. in year of our transcatheter increased innovations, Adjusted trial of the launch $XXX research to

Turning taxes. to

rate quarter reported or this adjusted Our was X.X%. tax X.X%

the during in per positive were second earnings in the the Our $X.XX non-GAAP rate by second quarter items rate benefited quarter. recorded quarter. several that onetime tax our favorability unexpected in unusually reflects favorable This share

million decreased negatively to adjusted year. quarter million sales by basis gross our compared impacted profit adjusted margin of reduced or the last Free prior the XXX for Foreign second year's by activities second FX to exchange rates growth special rates points with compared flow was cash the payments quarter $XX.X associated Care. $XX second to quarter second relating Critical points basis separation for quarter. XX

free cash million. Excluding the was impact of these adjusted items, $XXX flow

half free $XXX First million. was adjusted flow cash

receive sale Care expect cash quarter. in to We Critical the third from the of

balance the sheet. to Turning

with announcements. we with approximately June Critical as guidance to to flexible balance relating are an quarter. and sale update sale the I'll and strong of announced previously close the as well cash our that billion our a to comments Edwards to into announced now cash, Critical as third maintain about in planning finish XX. investments And in of sell short-term to continue sheet late We equivalents $X June on Care agreement Care entered acquisition and We X BD, this

second the During onetime costs sale. million with quarter, we of recorded $XX the associated

Additional onetime costs will XXXX. be incurred throughout

fourth to Critical for expect the of quarter and earnings expect We $X.XX billion, Care We in sale the QX We are recently billion the contribute announced do $X.XX including QX and own we announced to per of third assumption provide to full when Care the guidance share not that sales intend $X.XX acquisitions October. sales, in acquisitions $X.XX. reported XXXX. the to this quarter Edwards month reflecting Critical quarter of results to

York also early meantime, provide our guidance In conference XXXX investor We the will a expectations on XXXX. at New for in I'll X. share few December

we year, early-stage profit revenue planning operational operating the do Care from we We these of of following to planning offset companies, operating offset the Care. Critical acquisitions growth. not on from realize expenses Critical long-term in efficiencies but efficiencies sale expect increased while are healthy Next completely partially to the are of incremental we expect XXXX, profits we from loss minimal sale by plan

support and TMTT to to the for Endotronix addition, in reshape management acquire are Care to and Critical focus JenaValve extra of In growth provides we maintain time, share of businesses we to internal a to made companies and like balance high-quality sale at made portfolio on technologies potential high fund And investments continued reality, our additional plan liquidity strong The we specifically confident with structural we our repurchase. Most importantly, well early-stage investments investments. is well opportunistic moves as talented same as external sheet and becoming employees. external have heart. us to vision as the positioned in bandwidth a original the as

jewels of our benefit Edwards internal in portfolio the ahead. years external other have in and We that will investments

and will an Over term, large share growth. revenue the which result we per earnings in markets, we long believe expanded sustainable with exciting opportunities future see growing double-digit in and

to that, it with back pass I'll So Bernard.

Scott. you, Thank

us share So how opportunities, we long-term TMTT fundamentally over of thoughts. trials term. change exciting growth and globally expertise positioned a premium has TAVR patients TMTT, sustainable significantly growing few our by continue strategy portfolio for years. surgical science In strong are innovation technology. advancing early deep many to Heart, advance to TAVR, Surgical we see the our and over long and we of our committed closing to our enabled significant In global adoption let Progress AS are us me could have treated. strong Structural In

treat Our JenaValve in an therapy world represents allow Edward significant provide and more opportunities. to Endotronix both that therapeutic opportunity confident drive organic years strong new our patients areas. to They to expanded around We innovative in come. long-term growth acquisitions remain and continue the will the

significant As I that, transcatheter-based patients remain we as the technology, to benefit and ever it increasingly optimistic opportunity. With growth will back recognize as turn about of long-term the clinicians Mark.

Thank you, on Kevin, portion accessing with to of call. additional [Operator Q&A Bernard. ahead go now. details We're questions the ready Instructions] take the please

Larry first is Biegelsen [Operator Instructions] Fargo. coming Our question Wells from from

me. for Two

had early with XXXX. start for and then follow-up me Let a on TAVR Scott I

impact to I And expect compelling? If So study And X% is be think should do growth? you it to need would to about TAVR then to compelling early -- benefit expect be you? growth you XXXX your the on follow-up. in the X% you mortality be had accelerate what for the a year? one how to positive, this what above TAVR show more Do the TAVR, would we

for Sure. your Larry, this Thanks is question. Larry.

rehospitalization. of very for basically to and I endpoint we early think The against and be done needs primary make a of a intervention work there it. when and the And stroke powering obviously better high compelling is level, waiting. belief story in a why death, is the had lot were trial, case watchful a we we've lot -- the at

it it's really that you more composite trial. a and of the winning And so would more those win compelling by, all obviously, case. makes the And

why components, individual of waiting or a In composites it's and terms rehospitalization it's resulting waiting to journey, when But resulting endpoint. all happening the in we'll think in mortality, it's of and in to things look at from those. and are that's about unplanned or those are you in them it all stroke have they're they're meaningful bad if patient the why very resulting they're things

story, of but So to important We'll trials believe of kind wait rehospitalization because we'll these these have standard considerations the most now clinical community all death, the and the stroke and are almost see data. have a become to has for and endpoints. see

me what let to Larry said. Maybe add something little a

the things and very is For to thing in sure to many growing it community we are are doing, important to and all confident the opportunity. TAVR is But us and asymptomatic this we one patients. of of

So activation, asymptomatic moderate. also is patient see but some we one, already, impact

front we in to we confident, think us, see this expected. realize years about to Still is you see about is things we opportunity. Granted, in than over lower we the going a are confident guess if it, ago. this few So I doing that It one the we know a years, next are many that it. of talk saw see are was are big still all it and this we we QX opportunity But few we we And of TAVR why like catalysts. opportunity.

now That's I'm everyone try as right know helpful. to XXXX. color as can And this you try to thanks for that. understand initial to sure on the to call important on -- Scott, we model it's best that

that, confirm a growth. XX% reiterating today. I year XX% on says couple in analyst last December, doesn't It the strong follow-ups pieces, that. press to operational remaining meeting not of The you're just say the XXXX. that in from sustainable So want growth business for that release

And we spending proceeds, estimate, you think M&A? additional additional Any estimate or just we acquisitions. about Critical $X.XX lastly, just that? spin. share the Care the us color on the incremental use of most buyback dilution of the from assume should from second, I talked Any on about the of And reaction And to dilution, that?

follow-up Multipart right. All question.

me the to Let hit try about, asked couple a Larry. you things of

on guidance of top long-term the just the the course we're of XX% this It year. kind or or it all, changing don't we at decreasing mean the it's we're during where of not commenting increasing update just thing First it on line doesn't it, that point. growth,

we're providing not today. update an So

will provide we an We at December definitely update, our as do always conference. investor

dilution Care. Care, lot of lot upon as that. up moving yes, in we the And from Critical prioritizing different you can we For Critical this as do separate a how depends company end investments imagine, we a as of there pieces are

just you not incremental we're to I'll upon it does things. Care So closed to give And and specific we announced how can of is we it, start your when be realize point, these One end the absorbing expenses tie going we couple spending, on, about to and ex call those were acquisitions. imagine, them Edwards. that with you to today. actually of integrating a able a two, as RemainCo this them that depend acquisitions up figure operating And at question inside Critical

So those are developed. not completely plans

other investments. share allocating external Care. we'll Finally, invest to the to to on at is But of cash growth then proceeds first which back We're the looking in Yes, we're finally, need And to -- looking changed company. the one for going buyback. we're as at interested in capital always Critical know, company. support We're use stock. we that of buying capacity continue in in continue hasn't capital to opportunities. terms We'll buying you certainly always going the call from bit, to invest look be the of

as year. the the of bit we'll of little give towards and get color, a you there's lot So we obviously end more a

Scott not X%. planning you to But on company we were guidance. the the here about grew the what I with Maybe TAVR something, Larry, at XXXX. X%, about agree communicate if about the on guidance said look quarter,

So TMTT. as expansion. PASCAL that from just we of we bigger we Because at beginning see And get contribution see go. a are bigger you contribution right the now, to

expansion, TAVR, end year. coming the beginning in the the we of we MX EVOQUE asymptomatic have have on Just of

So are about long we sustainable Yes. growth over confident a the term?

about talk to going are December. We in guidance

today is Robbie question from JPMorgan. Marcus next The from coming

first, down, could competitors year. saw it expectations is Two for but year-over-year moved more more. in come clearly two slowing, give is you pressure. a has is see in taking Maybe U.S. their The me. script, for of the your initial and below little was talked competitors, about sequentially hoping you the TAVR I your TAVR still pretty so OUS smaller nice the guidance facing outside We help but U.S., growth are in TAVR opportunity, just huge conquer thinking appreciate Europe it's underlying And and How lot still a the it's you about rate and market? to the the of future. it, to about But a growth I to in there the market you in, is Japan. accelerate it? overall growth? call thinking how can let's are the do you the short medium anything term, has And

We March, QX, and rate in were slow QX higher growth in but had than exiting a good about felt expected where we we was. start to it were. obviously, Well, Robbie. be Thanks, we we

this a come did as surprise. So

of X in team growth in other rapid a going And hospitals. deeply to look to heart recently I it and more the on at procedures. think growth are repair. think back have mitral We're when have up tricuspid new these at all lot that seeing the about in structural we all space. We're the of we therapy things same we that you seeing had reflect shown approvals it,

of We I we little starting being burden things. these to the procedure underestimated these to it's just lot hospitals of teams. failures, looked have taxing think able good the screen the bit of and screen preparing think because new of programs a these even handle you programs, job shown pretty the a all even those probably volumes learning, to the things. start have there's And a new patients on, at early I

and come do help, the with of teach can once and add to things of come we can workups imaging down Now do optimized, those prep. off do them lot do in and really device has those things. help. take are to or things some things. we We certainly load sorts that does can of But can program can program We efficiencies and a terms days We additional there add do in been to team the to of benchmark another team. hospital the it the our do

are some we there So things do, we can everything. can't but do

And the things. the didn't the very data patients. think This of any lack thing some new is, change think, in this a slowdown I I these We because concerning terms isn't see of or for any of that of confident. other clinicians. was we're there's fundamentals highlighting

the workflow but think to just with right to longer. two an is from we And are in saw indicates patients be hospitals, of I which able a it's important we matter now. waiting engage time CT to saw things procedure, increase need we

other of versus the workflow routine. patients speaks cases saw to sharp And I we in number emergent a And that issues waiting these being in increase these that as coded queue the as was thing think sort the out.

certainly in with there's to So hospitals. but wait will through These the patients lot know don't work of continue we that a to hospitals that do have well, time. that and I think going them, to we're

the a we add me this To said. little on bit So we contributing same Larry time, be on fair, let what are are pressure. benefiting. At

benefiting TMTT growth the at time. contributing look in the so are we you and at same the If quarter,

picture. big Now a

facing workflows the are good learning, We good very in in they are to on hospital adopt, like don't they they you very technologies are trained at the similar we at have their seen this in do, new to cath scaling, technology adapting, good at and have be picture think lab. more past, very are to they more

on it And is believe are team So with Larry this are -- temporary. partnering this with also Daveen we one. we

to are focusing we in have like hospital hospital. do years. one, did fully on that, the So we faith, they this helping XX in last the it the going are But

the guide in of could you're half year. roughly to a to through quarter Guidance sounds implies need maybe And learnings in thought the that? TAVR stable of follow-up what half to process it the baking walk Great. I that. the Maybe X% second the just into kind and you TAVR back appreciate half. some second possibly help saw of conservative, first into X% the but like of be

little is we think end, that we've high quarter the baking is similar. that which for scenario similar we're first mean, comp low reported. gets with end, into bit likely I on Fourth the market pretty considered that -- the it, captures tougher, the already a half We're straightforward, all Yes. conditions the on the second pretty year-over-year it's but things X% half X% combined calculation

We already believe, almost that, a on TCT the what October. will in TAVR end to add quarter, in be Robbie, TCT. so of believe we at early late It

minimal it have very in we will So believe a impact QX.

didn't take risk too why is to it So want here. we much

Goldman from today question from Sachs. Roman David Next coming is

factor do or TAVR what it think and that, it's pricing it new now, back to whether is comments if right on wanted -- you EVOQUE? regarding kind some making prioritization how To WATCHMAN. heart does, here? of capacity. therapies, And whether into any going into extent come of way, decision hospital valve about I you decision around maybe impact of you're as in economics myriad the that the of Larry's does therapies just And structural characterizing think your the there actually some as

but economically start and Daveen Yes, don't a pricing, driven change I'll EVOQUE, good this TAVR an thing. really It it. the is the defer with on of think that's side we I'll doesn't question, and to

think of I make offer to these therapies, for want able new hospitals they are start come aggressively they and to of the to forward, offer that new means patients. competitive. They that all options want their when be can the programs therapies sure all and

things. than this more think And of so I some that's driving what's other

companies becomes And to queue have They all -- in, I and thing. has But patients driven they right? to economically in they're have have They screen. center don't is it ability technology to to before the demonstrate all they And those I confidence, things. an have think this the think thing. a a want new demonstrate to I think bring willing big

are think just all the to the result coming lab. things I I the that time. cath again, new with get of corrected it's that think And does

second a here. This in I'll is Daveen, for jump just

work about therapy, people lot we procedure takes up in new of relatively to a it seeing a start are, an thoughts, patients. we're cetera, processes EVOQUE, a groups are of efficient hour-long the lot do of these to therapy right? bandwidth How energy, procedures, new of takes working as bring terms and same et How TAVR. cardiologists, does It through are the trying the kind Where clinic it in like are are plan? right? of for coming they the often times people, And effort, coordinators, referrals on pre-case system? find valve from? interventional we that While they're So

lot every bring create is to hospitals lot more therapy and therapy, it going of system this its building And to get more in going. we're while going like the overall. a it way for you faster. up, more just it But takes over how as figure the through out, procedures So is other it start do therapy do work becomes and becomes efficiency, so a that, to bandwidth time, you of a gets we've new better it and help that then seen energy capacity then there efficient and okay, them now to but is a

$XX system? just then different drivers of that's follow-up sneak detail? the the a to sort you but a you could maybe maybe sounds then if some bit minimal accelerating. more therapies capacity for a the contribution multiple a if digestion bit that. Can this like takes of or different dislodge of you of through little unpack constraint the maybe delineate into there. in it drivers? And maybe there little going could in with think, of Larry, sort related follow-up response the But PASCAL do and long geographic It sort us And I How EVOQUE the product TMTT million in to line maybe

that tricuspid continues down forward believe high it becoming we start actually had commitment repair driver. PASCAL, mean, is that it technologies a was see QX. Ultimately, was of break many the and portfolio nice pool. more a right, in Daveen. Quarter at to and vision premium our grow level, it by differentiated in It our led technology, larger sales of we we a off made No, is PASCAL just We for TMTT. strategic in bit largest adoption. different were to replacement this in mitral We've step to I'll and a a growth this more patients, with excited and see X, super on reality. little first, were the that QX a level, I and

the also see late Europe last commercial Europe in We got earlier of year. year, in approved did early and in U.S. the U.S. introduction EVOQUE, this the right? EVOQUE

So train start case and important to centers of internal people getting we're kind training speed, cadence. to being that our beginning up process that own of

were base, Since quickly you U.S. because since you U.S. when two. size around just a terms kind of expand larger stronger a have XXXX in the kind growth have So larger the of technologies been that's we've our beyond And those continuing and in Europe, Europe coming scale, we're But now, the and in a up much Europe. is that. now, off and to just world growing the of base.

we other and on that there of in it is heard impact Yes. how light it's coronary long exact. try share into dislodge? sustainable. little brought little think And a to things us we in analogy and going cath a we space, our were procedures I -- of repeatedly for when we were guidance that best just but to up of that follow-up, that wasn't for hospitals, bit it take switch. the to all kind a and a on workflow was bit does can that But the It's be TAVR say not hard mind And we lab, these taking I account that

You can't AS forever. patients you forever park coronary can't park patients just and your

up. certainty are I think the to centers hire added the workload think They the a workload just high. kind go things certainty So that's bunch I and And how nobody and of they degree, as recovering people once gets systems do think in had volume, of hospital advance to the a of the But always I going the is new they have therapy of show resource of necessary. operate.

this confident a we are we processes. quality when experience, home, and to their workflow, patient, hospital them seeing temporary. Yes, by are Obviously, fast, you of terrible many this learn they adjust And stay dying. going their of the it why are have is are is life

and hospital everybody is to believe -- are it don't is committed, the committed, sustainable I are we So committed.

commitment it, behind know So we you be have going to when resolved. is a full it

Josh Next coming today question from Jennings TD Cowen. from is

by still put that thinking forecast -- in be outlook XXXX I the guys the start about Is longer place, just in know it in be little market with $XX a have maybe kind $XX reiterating wanted indication but by off TAM it TAVR out a not But kind the aortic billion being and Or there pushed gets billion to investors TAM term, the confident you that now. the sounds but bit? opportunity may you're I TAM, of TAVR but of if past. you're not that and you should sure regurgitation today, maybe you XXXX. I'm reiterating and like

Yes.

I think your said in it you question.

We confident. are

New York. the XXXX but do Conference We we Investor the we year, in confident are are market, for updating next will the for at December here so not in guidance on

is question of Next from coming Travis Steed from Bank America.

more Robbie's circle little a It there's here. on a bit go TAVR. back feels wanted like I back on question of to and change

year to guide. the thought conservative be ago, X was the of year. at a over the TAVR X% was you to of I going accelerate thought to the XX% months course Just beginning the supposed

So want that's I just but understand you're what of I small fractions -- the a like centers. overall number to saying hear versus on TMTT, TAVR

kind if else that of I and you line. last out you you'd call out TAVR quarter. what the know European stuff competition know on kind So the that there I called there don't there's of surprised was anything or of some

year? at full you why of start change of the the got guide Just this understanding wrong initial the TAVR and kind

reiterated that's that I mean QX, just we we we see Travis. the were by when we play is good felt Thanks, all on were fault guidance we about didn't accurate we exited and we means no ramp Yes. and on of number all pace, felt this way why a thought look at procedures. And that's a it. Yes, when we and fair or QX good And good out you do and EVOQUE in the to not anticipated. say it's we because that Daveen's

structural hit impact over cumulative of the the those one the it's think that things all teams heart And I have of it's year. last the things.

that to a and capacity, work all a reach go starting It's then volume. of lot simply consumes sorts it's just But cases harder. screening that of don't of too the interaction those is and a point, and little to procedure lift in little of the when training increase time. and increase things. just it's cases the all always training, And of a the can have And many lot reviews you centers resources case little a a heaviest you for the work You all capacity, harder, observed breakpoint little all and And a program. not a some much. at bit

They more have complications. it good fits outcomes think that to longer people those just I which well. of it's will so did the Emergent more small going earlier, people. patient but have time. in as the and centers slowdown sustainable cases And length we're of see to that for things are adversely routine that's acutely cumulative see competitive bit a that's over did of think the and impact themselves. little and about what be impact and large centers, And not have happen stay, to as looking we saying centers don't in as cases. new model emergent of terms to be we in the a that. And And start I of well I going But patients fits programs cases and spike said that the hospitals most are likely these again, over

adjust help So closely have with to to do I think And them people we're have to will over going time. to it that. them work

don't the -- selling Critical on but that and kind all that you've That's guide? you the going to All deal have of a if got, to had a just in a we but thinking all? outcomes, out TAVR I on was of know a QX year like days from But settling dilution Care good the the pretty there's that's sense of versus some and like of full I extra $X.XX think that's of is be then on QX. And like guys acquisitions, kind I to of at color of dilution I dilution kind range ballpark, know give the Any of outcomes right. there. react sense where range you'd helpful.

days question, you're quarter. for little third right, in guide Travis. in provided. the extra our It's factored And do a from that into selling On help we Thanks we that's the QX, the have guidance.

time implications acquisitions In but before conference. more Obviously, for and kind we'll at time of full to out a close are talk terms plan, EPS guidance can of quarter investor recording those. down we there in-house report next the on the end in on some of dilution it further by we've the path, of from acquisitions, before gotten lot got integrating them. and a what the And first we'll work actually our then we've again, give it spent and with we when XXXX We'll course, actually financial know takes about get lot of start we then. businesses

is Matt Taylor Jefferies. from today coming question from Next

still I wanted put do issue? long additional a U.S. you're you this or and will you help up angle history this time the and them on issue showing to you in accommodate commentary to you because understand on it I of the for to seeing now, why up frame guess, guess been I What rollout Is could a think of How years? an impact hospital it it workflows? for Does better X take acutely us some so And just workflow adjusting now? would I'd on follow quarter more kind to we're EVOQUE, that's talked TAVR the the of like your limited understand while, X-quarter is given a your about there, adjust? matriculating you take coronary. it's think

for draw always if Matt. bit of product excess hours guess, demand The I and things. can an say going you always adjust is, and can a you more your would little factory to and add that you you you I had a Thanks, those little to a Yes. thing up, have capacity I if were analogy, saw

a And I saw these what think It's of and you of hit I little things time out do time. that's there that played effect to have it's here. we all cumulative things. is bit those of in just where a a harder point wall the think over

when are and with closely If to the period it's we'll wanted and that do to corrected as not And these to. happy be probably it just work a we time. these adjusting you're and with on to we're none you in everything think will are But think part structural starting the new our us look it. in to do And should team the the happened. going restore of be. X reflected I toned us after thing But same is during of to to tell and are growth take over I happy having that is we close hospitals the realistic the these heaviest guidance, can again, cath it lot growth new double rates. for adapt therapies, what's None which gets of to last that time, as of lift and working we can having at you heart lab to where to I'll that. be be hard of procedures time, they're the And this teams years, guidance we total absorb that's think programs again, growth

hospitals are not the the happy. happy a not happy, patients happy, are as not company. The not are we And are physicians

it So solve is problem, we about need are we fully all a aligned to it.

is confident why also are we So it here.

Evercore from Kumar ISI. Vijay from comes question Next

based been -- one what not know this what how U.S. do Is guess you competition seeing respond like trial. just comparative on on dynamics, is is saying, the annuli there's -- in noise I small I on to we're market?

Valves, competitors that data the growing any base New way. and have rates reported, to know in but their have off don't I of I of we're the think versus the off Yes. globally. consideration base some presented smaller they're York the of our you meaningful We seen in growth Sure. we've that impact of Yes. take at of growing

Is $X.XX intact to Critical or the that right? what's And Understood. for an baseline. sort get inclusive guidance, one want EPS Scott, of still $X.XX EPS, here, the maybe, Care, I I guidance apples-to-apples range? new you think of just on to prior at

Yes, it's fair question. a

We Critical fourth Care. update. sometime will to are we not is result, late quarter. know providing a But include Care not the quarter Critical reason in new going And third as a the close is because

And at to try forma $X.XX of bridge a some the pro make so didn't we looked $X.XX scenarios, of run -- to different a whole guidance. to sense kind it obviously, bunch but provide to we've original

of updated not it we're just number out coming but the Critical third because sorry, not giving an the So for the at be full company end it's quarter. wouldn't comparable Care -- with

Or without underlying the full is comparable for what Critical number there is? the year, Care like a

underlying and the growth terms Care. pretty rate Critical Well, is with number in of without actually similar

Our full it full guidance company growth. underlying X% is full Care or Critical for the year Critical year. excludes the for whether for similar the That's XX% includes Care to

with We not have or to translated down that without. EPS

coming Wood Stanley. is Morgan from question next Your Patrick from

and of been the clinical feedback in rollout the of guys ones. database. you quick has little bit volatility rate success the initial two on Just I side guess that have How been and more a There's EVOQUE going? the had.

So feedback been. I'm just curious how has the clinician

of Europe. we've much, is Patrick. with EVOQUE pull initial actually Overall, in the rollout very U.S. been pleased both you This so if back, Thanks and Daveen. the

for We better are continue to of for reinforces see physician really, patient really it the looking unmet us, solutions. groups need these who strong and demand

II. to saw similar clinical TRISCEND those earlier, I we're to seeing what just at very ] mentioned clinical outcome results trials, trials. seeing in from We're to predictable the the seeing look As [ times. clinical it And we we're similar specifically

seen need So in actually for outcomes. that is there of number the we've journey, rates treat We've We EVOQUE. where clinical the the replacement PASCAL the both now similar repair Europe far reinforces technology been so it and very seeing EVOQUE approved of maximum see really especially in for the of kind to patients.

be very EVOQUE where continue we the and excited happy is to going. with overall, launch So

looks initially into fitting and it the the ] Very it this used very about you [ ] Harry interesting. see probably How right? quickly I more then at medication downstream Rolodex approach? for just understanding to do that strategically clinical helpful. side and fine-tuning on you do you Is transcatheter them the be Endotronix. Because know How overall? was for so like my THT business little would a a this their [ was And data the on building bit patients comes Ariel management, fitting maybe better in? of see this when that with

the for question. Thanks

largest big Heart a the of failure health because start get decided field driver this very one-off, in with care into not me patient let So in picture is the first need. U.S. population see the spending We patients. of we if to large

We have month. There not fact, technology. We company. from unique the progression a right investor were an label have And for a been company FDA long as for a natural an in is a technology, opportunity, now the broad a in time. see that believe differentiated that ongoing big we We of so receive very as matter they a last us. NCD they

a Endotronix. have patients, we that what patients technologies. close on a full If this, are clear And we the these to are serving and is today our with we strategy do, to will transaction in of treating start, about bit you're here. Again, little we going all the Scott strategy to asking a very of valve where about in dive many failure going are for it quarter, third deep are we early. expect correct. the patients December, We believe are

in is it our So space.

this opportunity, So super great we company. are as as one a a to opportunity great long-term our a expand it. We see excited about reach

to of have floor We reach question-and-answer I'd our turn the end Bernard over comments. any for to back like session. closing the further

Scott, interest Thank in for welcome questions telephone. a continued and everyone, much. additional your so Edwards. by great your day. I you, you Have of rest Thank Mark, any

teleconference does That webcast. you. conclude Thank today's and

time, have this your and day. We participation a at for line your you disconnect may wonderful You today. thank