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Goodwill and Intangible Assets (Tables) | 12 Months Ended
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Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract] |
Changes in carrying amount of goodwill | The changes in the carrying amount of goodwill for the years ended December 31, 2024 and 2023, are as follows (in thousands):
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | 2024 | ​ | 2023
​ |  | Cardiovascular | ​ | Endoscopy | ​ | Total |  | Cardiovascular | ​ | Endoscopy | ​ | Total
Goodwill balance at January 1 | ​ | $ | 382,240 | ​ | $ | — | ​ | $ | 382,240 | ​ | $ | 359,821 | ​ | $ | — | ​ | $ | 359,821
Effect of foreign exchange | ​ |  | (1,623) | ​ |  | — | ​ |  | (1,623) | ​ |  | 883 | ​ |  | — | ​ |  | 883
Additions and adjustments as the result of acquisitions | ​ |  | 65,897 | ​ |  | 16,997 | ​ |  | 82,894 | ​ |  | 21,536 | ​ |  | — | ​ |  | 21,536
Goodwill balance at December 31 | ​ | $ | 446,514 | ​ | $ | 16,997 | ​ | $ | 463,511 | ​ | $ | 382,240 | ​ | $ | — | ​ | $ | 382,240
Other intangible assets | Other intangible assets at December 31, 2024 and 2023, consisted of the following (in thousands):
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | December 31, 2024
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 31,489 | ​ | $ | (12,824) | ​ | $ | 18,665
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,994) | ​ |  | 256
License agreements | ​ |  | 11,557 | ​ |  | (9,125) | ​ |  | 2,432
Trademarks | ​ |  | 47,613 | ​ |  | (24,177) | ​ |  | 23,436
Customer lists | ​ |  | 57,933 | ​ |  | (36,223) | ​ |  | 21,710
Total | ​ | $ | 151,842 | ​ | $ | (85,343) | ​ | $ | 66,499
​
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | December 31, 2023
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 28,877 | ​ | $ | (10,916) | ​ | $ | 17,961
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,919) | ​ |  | 331
License agreements | ​ |  | 11,142 | ​ |  | (8,327) | ​ |  | 2,815
Trademarks | ​ |  | 35,135 | ​ |  | (20,804) | ​ |  | 14,331
Customer lists | ​ |  | 40,367 | ​ |  | (33,921) | ​ |  | 6,446
Total | ​ | $ | 118,771 | ​ | $ | (76,887) | ​ | $ | 41,884
Estimated amortization expense | Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2024 (in thousands):
​ | ​ | ​ | ​
Year ending December 31, |  | Estimated Amortization Expense
2025 | ​ | $ | 83,747
2026 | ​ |  | 73,155
2027 | ​ |  | 69,188
2028 | ​ | ​ | 67,790
2029 | ​ |  | 56,115
​

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