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Geographic and Segment Information
 3 Months Ended
Mar. 31, 2021
Segment Reporting [Abstract]  
Geographic and Segment Information
Note 13. Geographic and Segment Information
We identify operating segments based on the way we manage, evaluate and internally report our business activities for purposes of allocating resources, developing and executing our strategy, and assessing performance. We have two reportable segments: Cardiovascular and Neuromodulation.
The Cardiovascular segment generates its revenue from the development, production and sale of cardiopulmonary products, heart valves and related products and advanced circulatory support. Cardiopulmonary products include oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Advanced Circulatory
Support includes temporary life support product kits that can include a combination of pumps, oxygenators, and cannulae. Heart Valves include mechanical heart valves, tissue heart valves, related repair products and minimally invasive surgical instruments. Advanced circulatory support includes temporary life support controllers and product kits that can include a combination of pumps, oxygenators, and cannulae.
Our Neuromodulation segment generates its revenue from the design, development and marketing of neuromodulation therapy systems for the treatment of drug-resistant epilepsy, difficult-to-treat depression (“DTD”) and obstructive sleep apnea. 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.
“Other” includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development.
Net sales of our reportable segments include revenues from the sale of products that each reportable segment develops and manufactures or distributes. We define segment income as operating income before merger and integration, restructuring and amortization of intangibles.
We operate under three geographic regions: U.S., Europe, and Rest of World. The table below presents net sales by operating segment and geographic region (in thousands):
Three Months Ended March 31,
20212020
Cardiopulmonary
United States$35,759 $36,858 
Europe30,626 34,234 
Rest of World42,334 45,275 
108,719 116,367 
Heart Valves
United States2,717 3,373 
Europe8,284 9,529 
Rest of World10,454 12,309 
21,455 25,211 
Advanced Circulatory Support
United States12,560 10,076 
Europe228 370 
Rest of World204 45 
12,992 10,491 
Cardiovascular
United States51,036 50,307 
Europe39,138 44,133 
Rest of World52,992 57,629 
143,166 152,069 
Neuromodulation
United States82,300 73,276 
Europe11,679 10,583 
Rest of World9,720 5,798 
103,699 89,657 
Other738 671 
Totals
United States133,336 123,583 
Europe (1)
50,817 54,716 
Rest of World63,450 64,098 
Total (2)
$247,603 $242,397 
(1)Europe sales include those countries in which we have a direct sales presence, whereas European countries in which we sell through distributors are included in Rest of World.
(2)No single customer represented over 10% of our consolidated net sales. No country’s net sales exceeded 10% of our consolidated sales except for the U.S.
The table below presents a reconciliation of segment income from continuing operations to consolidated income from continuing operations before tax (in thousands):
Three Months Ended March 31,
20212020
Cardiovascular $5,628 $8,681 
Neuromodulation 34,039 33,858 
Other(30,669)(26,610)
Total reportable segment income from continuing operations8,998 15,929 
Merger and integration expenses630 3,474 
Restructuring expenses6,092 1,580 
Amortization of intangibles6,699 10,267 
Operating income from continuing operations(4,423)608 
Interest income(74)148 
Interest expense(15,936)(4,849)
Foreign exchange and other losses(6,369)(1,914)
Income from continuing operations before tax$(26,802)$(6,007)
Assets by segment are as follows (in thousands):
March 31, 2021December 31, 2020
Cardiovascular$1,319,493 $1,361,669 
Neuromodulation 642,123 673,586 
Other407,553 376,096 
Total assets$2,369,169 $2,411,351 
Capital expenditures by segment are as follows (in thousands):
Three Months Ended March 31,
20212020
Cardiovascular$4,149 $5,292 
Neuromodulation 40 5,239 
Other925 1,843 
Total$5,114 $12,374 
The changes in the carrying amount of goodwill by segment for the three months ended March 31, 2021 were as follows (in thousands):
CardiovascularNeuromodulationTotal
December 31, 2020$523,564 $398,754 $922,318 
Foreign currency adjustments(12,326)— (12,326)
March 31, 2021$511,238 $398,754 $909,992 
Property, plant and equipment, net by geography are as follows (in thousands):
March 31, 2021December 31, 2020
United States$64,002 $64,553 
Europe87,945 93,821 
Rest of World5,945 5,431 
Total$157,892 $163,805