Financial Data and Key Metrics Changes - For the full year 2025, total adjusted constant currency revenue growth was 13% and adjusted EBITDA growth was 26% year-over-year, resulting in positive free cash flow while investing in future growth [5][17] - Total adjusted revenues for Q4 2025 were $118.3 million, up 18.5% compared to Q4 2024, with adjusted EBITDA increasing approximately 29% from $17.6 million to $22.7 million [16][17] - Adjusted EBITDA margin was 19.2% in Q4 2025, an improvement of approximately 110 basis points over the prior year [17] Business Line Data and Key Metrics Changes - Stent graft revenues grew 36% on a constant currency basis in Q4 2025, driven by AMDS in the U.S. and strong international growth [6][20] - On-X revenues increased 24% year-over-year on a constant currency basis, supported by global market share gains and new U.S. market opportunities [7][8] - Tissue processing revenue increased 6% year-over-year, while BioGlue revenues were flat compared to the same period last year [8][20] Market Data and Key Metrics Changes - Revenues in Asia Pacific increased 32%, North America increased 18%, EMEA increased 17%, and Latin America increased 9% compared to Q4 2024 [21] - Gross margins were 63% in both 2025 and 2024, with the 2024 margin negatively impacted by an idle plant charge due to a cybersecurity incident [21] Company Strategy and Development Direction - The company plans to replicate its strategy by introducing additional stent graft products from Europe to the U.S. and Japan, aiming to expand its total addressable market [7] - Key growth drivers include AMDS commercialization in the U.S., On-X heart valve data, NEXUS PMA, and the ARTISAN IDE trial [33][34] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's growth strategies, anticipating continued double-digit revenue growth and EBITDA margin expansion [14][28] - The company expects constant currency growth between 10%-14% for the full year 2026, with specific growth rates for different product lines [25][27] Other Important Information - The company recorded a $2.3 million adjustment to revenue for estimated payback obligations due to Italian government legislation, which has been excluded from adjusted revenue [18][19] - Free cash flow for the full year was approximately $1 million, despite significant investments in the business [24] Q&A Session Summary Question: Impact of Italian clawback on growth - Management clarified that the Italian payback was specific to the EMEA line and did not impact major product lines [39] Question: Sell-in versus sell-through for AMDS - Management noted that implantations are continuing to grow and emphasized the importance of positive first experiences for surgeons [42] Question: Progress on AMDS target accounts - Management indicated that they are in the early stages of account openings and expect significant growth in 2026 [46] Question: Market opportunity for NEXUS - Management described the NEXUS market as nascent, with a U.S. market opportunity of $150 million, and expressed confidence in gaining market share [50] Question: Pricing for AMDS and NEXUS - Management affirmed that the pricing assumptions for AMDS and NEXUS remain appropriate due to favorable reimbursement conditions [56] Question: CapEx plans for 2026 - Management indicated that the increased CapEx is primarily for capacity expansion for On-X and internal IT investments [75]