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ATSI > SEC Filings for ATSI > Form 10-Q on 13-May-2009All Recent SEC Filings

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Form 10-Q for ATS MEDICAL INC


13-May-2009

Quarterly Report


ITEM 2. Management's Discussion and Analysis of Financial Condition and Results
of Operations
This document contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Words such as "may," "expect," "believe," "anticipate" or "estimate" identify such forward-looking statements. These statements by their nature involve substantial risks and uncertainties, and actual results may differ materially from those expressed in such forward-looking statements. The factors that could cause such material differences are identified in Part I, Item 1A of our Annual Report on Form 10-K for the fiscal year ended December 31, 2008. We undertake no obligation to correct or update any forward-looking statements, whether as a result of new information, future events or otherwise. You are advised, however, to consult any future disclosures we make on related subjects in future filings with the SEC.
Executive Overview
ATS Medical, Inc. (hereinafter the "Company", "ATS", "we", "us" or "our") develops, manufactures, and markets medical devices. Our primary interest lies with devices for the treatment of structural heart disease used by cardiovascular surgeons in the cardiac surgery operating theater. Currently, we participate in the markets for heart valve therapy including mechanical bileaflet replacement heart valves, tissue heart valves and valve repair products and the surgical treatment of cardiac arrhythmias, primarily the treatment of atrial fibrillation. Additionally, a small portion of our business is surgical tools and accessories used by the cardiac surgeon.
In 1990, we licensed a patented and partially developed mechanical heart valve from CarboMedics, Inc. Under the terms of the license, we would complete the development of the valve and agreed to purchase carbon components from CarboMedics. As a result, ATS now holds an exclusive, royalty-free, worldwide license to an open pivot, bileaflet mechanical heart valve design owned by CarboMedics. In addition, we have an exclusive, worldwide right and license to use CarboMedics' pyrolytic carbon technology to manufacture components for the ATS mechanical heart valve. We commenced selling the ATS mechanical heart valve in international markets in 1992. In late 2000, we received U.S. Food and Drug Administration ("FDA") approval to sell the ATS Open Pivot mechanical heart valve and commenced sales and marketing of our valve in the United States. During 2002, we reorganized the Company and began the process of rebuilding our sales and marketing teams, both in the United States and internationally. This rebuilding has been a significant factor in our operating expense levels since 2002. During 2004 and 2005, we developed and implemented a plan to ramp-up our own manufacturing facility for pyrolytic carbon. By the end of 2005, this process was substantially complete.
During 2004, we made our first investments outside the mechanical heart valve market. We completed a global partnership agreement with CryoCath Technologies, Inc. ("CryoCath") to market CryoCath's surgical cryotherapy products for the ablation of cardiac arrhythmias. CryoCath developed a portfolio of novel products marketed under the SurgiFrost® and FrostByte® trade names which are used by cardiac surgeons to treat cardiac arrhythmias. Treatment is accomplished through the creation of an intricate pattern of lesions on the surface of the heart to block inappropriate electrical conduction circuits which cause the heart to be less effective when pumping blood and can lead to stroke, heart failure and death. Unique to this technology is the use of cryothermy (cold) to create lesions. The agreement with CryoCath has resulted in revenues for ATS since 2005.
During 2005, we continued to expand our business outside the mechanical heart valve market. We entered into an exclusive development, supply and distribution agreement with Genesee BioMedical, Inc. ("GBI") under which GBI will develop, supply and manufacture cardiac surgical products to include annuloplasty repair rings and bands and accessories, and we will have exclusive worldwide rights to market and sell such products. Our agreement with GBI has produced revenues for us since 2006.
In 2006, we completed the acquisition of all the voting and non-voting stock of 3F Therapeutics, Inc., a privately-held medical device company specializing in manufacturing tissue heart valves. The acquisition was consummated pursuant to an agreement and plan of merger, as amended ("the Merger Agreement"). Under the terms of the Merger Agreement, upon closing, we paid each 3F stockholder its pro-rata portion of an initial payment of 9,000,000 shares of our common stock, subject to certain adjustments. In addition to the initial closing payment, we are obligated to make additional contingent payments to 3F stockholders of up to 10,000,000 shares of our common stock with shares issuable upon obtaining each of the CE mark and FDA approval of certain future key products on or prior to December 31, 2013. Milestone share payments may be accelerated upon completion of certain transactions involving these future key products. Our current first generation tissue valve, the ATS 3f Aortic Bioprosthesis, has received the CE mark and is available for sale in Europe and certain other international markets. In the United States, we received FDA approval of this product in October 2008.


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Also in 2006, we entered into an exclusive distribution agreement with Novare Surgical Systems, Inc. ("Novare"). Novare is the owner of the Enclose II® cardiac anastomosis assist device, which is a device used by cardiac surgeons to attach a bypass vessel to the aorta during coronary artery bypass graft surgery. Under the terms of the agreement, we hold the exclusive right to market, sell and distribute the Enclose II product in the United States, Germany, France and the United Kingdom. We agreed to pay to Novare a transfer price for each box of Enclose II product we purchase.
In June 2007, we acquired the cryoablation surgical device business of CryoCath. The acquisition included the SurgiFrost, FrostByte and SurgiFrost XL family of products for which we served as CryoCath's exclusive agent in the United States and distributor in certain international markets. Under the acquisition agreements, we paid CryoCath $22.0 million upon closing of the transaction (reduced by $0.9 million subsequent to closing) and $2.0 million during 2008 upon the achievement of certain manufacturing transition milestones. We must also pay $2.0 million two years after closing and up to $4.0 million in contingent payments based on future sales of Surgifrost XL, an FDA cleared and CE Marked product designed to enable less-evasive ablations. This technology enables us to leverage our current operating infrastructure and allows us to better address the rapidly growing $130 million cardiac arrhythmia market within cardiac surgery. The transaction was financed with a portion of the proceeds of an $8.6 million senior secured Term Loan from Silicon Valley Bank and the private placement of 9,800,000 shares of our common stock at a purchase price of $1.65 per share to Alta Partners VIII, L.P., a life sciences venture capital firm.
Critical Accounting Policies and Estimates We base our estimates on historical experience and on various other assumptions that we believe to be reasonable under the circumstances. Management's discussion and analysis of financial condition and results of operations are based upon the consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States. The preparation of these financial statements requires us to make estimates and judgments that affect (1) the reported amounts of assets, liabilities, revenues and expenses; and (2) the related disclosure of contingent assets and liabilities. At each balance sheet date, we evaluate our estimates and judgments. The critical accounting policies that are most important to fully understanding and evaluating our financial condition and results of operations are discussed in our most recent Annual Report on Form 10-K on file with the SEC.
See Note 10 of "Notes to Consolidated Financial Statements" in Item 1 of this Form 10-Q for information on recently issued accounting pronouncements which will or could affect our accounting policies and estimates.


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Results of Operations
The following table provides the dollar and percentage change in the Statements
of Operations for the quarterly periods ended April 4, 2009 and March 29, 2008.

                                               Quarter ended April 4 (March 29)
                                                                    Increase (Decrease)
      (in thousands)                    2009          2008            $             %

      Net sales                      $  18,403     $  14,845      $  3,558         24.0 %
      Cost of goods sold                 6,130         5,897           233          4.0 %

      Gross profit                      12,273         8,948         3,325         37.2 %

      Operating expenses:
      Sales and marketing                7,501         6,487         1,014         15.6 %
      Research and development           2,044         2,206          (162 )       (7.3 )%
      General and administrative         2,476         3,004          (528 )      (17.6 )%
      Amortization of intangibles          788           891          (103 )      (11.6 )%

      Total operating expenses          12,809        12,588           221          1.8 %

      Operating loss                      (536 )      (3,640 )      (3,104 )      (85.3 )%

      Net interest expense                (719 )        (619 )         100         16.2 %
      Other income (expense), net         (353 )       1,918        (2,271 )     (118.4 )%


      Net loss before income taxes      (1,608 )      (2,341 )        (733 )      (31.3 )%
      Income tax expense                   (63 )         (70 )          (7 )      (10.0 )%


      Net loss                         ($1,671 )     ($2,411 )    $   (740 )      (30.7 )%

The following table presents the Statements of Operations as a percentage of net sales for the quarterly periods ended April 4, 2009 and March 29, 2008.

                                                     Quarter ended
                                                   April 4 (March 29)
                                                   2009          2008

                Net sales                          100.0 %      100.0 %
                Cost of goods sold                  33.3 %       39.7 %

                Gross profit                        66.7 %       60.3 %
                Operating expenses:
                Sales and marketing                 40.8 %       43.7 %
                Research and development            11.1 %       14.9 %
                General and administrative          13.5 %       20.2 %
                Amortization of intangibles          4.3 %        6.0 %

                Total operating expenses            69.6 %       84.8 %

                Operating loss                      (2.9 )%     (24.5 )%

                Net interest income (expense)       (3.9 )%      (4.2 )%
                Other income (expense), net         (1.9 )%      12.9 %


                Net loss before income taxes        (8.7 )%     (15.8 )%
                Income tax expense                  (0.3 )%      (0.5 )%


                Net loss                            (9.1 )%     (16.2 )%


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Net Sales. The following table provides the dollar and percentage change in net sales inside and outside the United States for the quarterly periods ended April 4, 2009 and March 29, 2008.

                                            Quarter ended April 4 (March 29)
                                                                     Increase
             (in thousands)             2009         2008          $          %


             United States           $  7,932     $  5,830     $ 2,102       36.1 %

             Outside United States     10,471        9,015       1,456       16.2 %


             Total                   $ 18,403     $ 14,845     $ 3,558       24.0 %

The following table provides net sales inside and outside the United States as a percentage of total net sales for the quarterly periods ended April 4, 2009 and March 29, 2008.

                                                 Quarter ended
                                               April 4 (March 29)
                                                2009         2008


                    United States                43.1 %       39.3 %

                    Outside United States        56.9 %       60.7 %


                    Total                       100.0 %      100.0 %

The following table provides net sales by product group for the quarterly periods ended April 4, 2009 and March 29, 2008.

                                                Quarter ended April 4 (March 29)
                                                                    Increase (Decrease)
      (in thousands)                      2009         2008           $             %

      Heart valve therapy              $ 13,245     $ 10,681      $  2,564         24.0 %

      Surgical arrhythmia                 4,904        3,848         1,056         27.4 %

      Surgical tools and accessories        254          316           (62 )      (19.6 )%


      Total                            $ 18,403     $ 14,845      $  3,558         24.0 %

Total net sales in the first quarter of 2009 increased 24% over the same period in 2008. Our net sales increase was negatively impacted by approximately 3.6% of net sales due to lower foreign currency exchange rates against the U.S. dollar. Approximately 20% of our total sales in the first quarter of 2009 were invoiced in Euros or other local currencies in European markets where we sell our products directly to hospitals.
Heart valve therapy sales, our largest product group, consists of mechanical and tissue heart valves and heart valve repair products. Our mechanical heart valve products continue to be our primary product line and comprised approximately 59% of our total worldwide sales for the first quarter of 2009, compared to 66% for the same period in 2008. Surgical arrhythmia therapy products consist of cryotherapy products for the ablation of cardiac arrhythmias. We acquired this business from CryoCath in 2007. Surgical tools and accessories consist primarily of cardiac anastomosis assist devices and thoracic port systems.
Worldwide mechanical heart valve revenue in the first quarter of 2009 increased 12% from the same period in 2008. U.S. mechanical heart valve revenue in the first quarter of 2009 also increased 12% from the same period in 2008, the result of the introduction of a new mechanical valve offering in 2008, the AP 360 valve, which allowed us to take market share from competitors. International mechanical heart valve revenue also increased approximately 12% in the first quarter of 2009 compared to the same period a year ago, due primarily to stronger mechanical heart valve sales in Asia and other developing markets. Tissue heart valve revenue increased 378% in the first quarter of 2009 to $1.1 million, driven primarily by the limited commercial launch of the Company's first generation U.S. tissue valve product, the ATS 3f Aortic Bioprosthesis, approved by the FDA in October 2008. U.S. tissue valve revenue comprised more than 50% of total tissue valve revenue in the first quarter of 2009.


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Heart valve repair revenue increased 76% in the first quarter of 2009 to $1.2 million, due to the introduction of our semi-rigid line of repair rings in the first quarter of 2008 as well as to continued sales growth of our existing repair ring products.
Surgical arrhythmia therapy revenue in the first quarter of 2009 of $4.9 million increased 27% compared to the same period in the prior year. Cryotherapy products in general and CryoMaze procedural growth in particular has benefited from the overall growth of the surgical ablation market and increased market acceptance of cryo-energy (cold) as a preferred technology to perform Cox-Maze lesion sets.
Cost of Goods Sold and Gross Profit. Our first quarter 2009 gross profit percentages of net sales improved to 66.7% from 60.3% for the same period in the prior year.
Our first quarter 2009 gross profit has benefited significantly from lower product manufacturing costs, particularly for mechanical heart valves. The cost declines are attributable primarily to higher manufacturing volumes as a result of increased demand. Lower product costs increased our first quarter 2009 gross profit as a percentage of net sales by approximately 8.0 percentage points compared to the first quarter of 2008. Also contributing to the higher first quarter 2009 gross profit percentage was higher U.S. average selling prices, attributable in large part to tissue valves, which increased our first quarter 2009 gross profit as a percentage of net sales by approximately 2.3 percentage points compared to the first quarter of 2008.
Partially offsetting the improved first quarter 2009 gross profit percentage of net sales were (1) shifts in the overall product mix to lower margin products, which decreased our first quarter 2009 gross profit as a percentage of net sales by approximately 1.5 percentage points compared to the first quarter of 2008 and
(2) lower international selling prices due to foreign currency exchange rate changes and sales mix shifts to lower-margin countries, which had a net unfavorable impact on our first quarter 2009 gross profit as a percentage of net sales of approximately 2.7 percentage points compared to the same period in the prior year. Sales and Marketing. In the United States, our sales and marketing costs for the first quarter of 2009 increased approximately 24% over the same period in the prior year, to $4.9 million. The increase reflects costs for additional marketing personnel and higher marketing program costs, particularly for our tissue heart valve and repair ring businesses. Field selling costs in the United States were 10% higher in the first quarter of 2009 compared to the same period in the prior year, reflecting higher commissions and sales incentive accruals for territory managers and independent sales representatives connected with increased first quarter 2009 sales in the United States. Internationally, our sales and marketing costs for the first quarter of 2009 increased approximately 2% over the same period in the prior year to $2.6 million. The increase is attributable to our continuing investment in international markets, evidenced by the establishment of a European support office in Belgium during the second half of 2008 to continue the support and expansion of our direct sales operations in Europe, offset by the impact of declining Euro-to-U.S. dollar foreign exchange rates during 2009. Approximately 75% of our international sales and marketing costs for the first quarter of 2009 were denominated in Euros. Research and Development. Research and development ("R & D") expenses for the first quarter of 2009 decreased 7% compared to the same period in the prior year to $2.0 million. The decrease reflects lower direct tissue valve R & D, lower clinical program costs for tissue valves and prior year development and start-up costs for surgical cryoablation manufacturing. These declines were partially offset by higher R & D headcount and new product development costs. General and Administrative. General and administrative ("G & A") expenses for the first quarter of 2009 decreased $0.5 over the same period in 2008 to $2.5 million. The primary driver behind this decline was significantly lower legal fees ($0.8 million) after the fourth quarter 2008 settlement of the litigation with CarboMedics. Cost increases in G & A expenses for the first quarter of 2009 over the same period in 2008 were for compensation and benefits ($0.1 million) and other personnel-related expenditures ($0.1 million). In the first quarters 2009 and 2008, we recognized total stock compensation expense of $0.5 million and $0.3, respectively. Stock compensation expense has been allocated to sales and marketing, R & D and G & A expenses as indicated above in Note 2 of "Notes to Consolidated Financial Statements" in this Form 10-Q. The increase in stock compensation expense is attributable primarily to new equity grants and awards, lower forfeitures and a higher number of days in the first quarter of 2009 compared to the prior year first quarter.


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Amortization of Intangibles. Amortization expense for the first quarter of 2009 decreased $0.1 million over the same period in the prior year to $0.8 million, attributable primarily to the prior year accelerated amortization of the trademark intangibles acquired in our 2007 purchase of the surgical cryoablation business of CryoCath. Amortization expense for both 2009 and 2008 also includes amortization of our pyrolytic carbon technology license with CarboMedics as well as amortization of definite-lived intangible assets acquired in connection with our 2006 acquisition of 3F. We estimate amortization expense for 2009 to total approximately $3.3 million.
Net Interest Expense. Net interest expense for the first quarter of 2009 increased $0.1 million over the comparable period of the prior year, reflecting primarily lower interest income on cash and investment balances. Net interest expense includes interest on the $8.6 million Term Loan with Silicon Valley Bank obtained in connection with the 2007 CryoCath asset acquisition. See "Liquidity and Capital Resources-Financing Activities" below for a detailed discussion of the Term Loan. Net interest expense also includes interest on $22.4 million aggregate principal amount of 6% Convertible Senior Notes issued in 2005. Interest expense on these Notes includes amortization of
(1) financing costs, (2) the discount related to the implied value of common stock warrants sold with the Notes, and (3) the discounts related to the bifurcated Convertible Senior Notes derivatives. See Note 7 of "Notes to Consolidated Financial Statements" in this Form 10-Q for more information regarding the Notes. Other Income (Expense). The following table summarizes our net other income (expense) for the first quarters of 2009 and 2008:

                                                                       Quarter ended April 4 (March 29):
(in thousands)                                                           2009                    2008

Alta warrant liability gain                                         $          -            $        1,520
Convertible Senior Notes derivative liability gain                             9                        15
Net realized foreign currency transaction gain (loss)                       (229 )                     247
Unrealized foreign currency gain (loss) related to
short-term intercompany balances with foreign subsidiaries                  (133 )                     136

Net other income (expense)                                          $       (353 )          $        1,918

In our June 2007 private equity placement in connection with the acquisition of the surgical cryoablation business of CryoCath, we sold to Alta 9,800,000 shares of our common stock and a seven-year warrant to purchase up to 1,960,000 shares of our common stock at an exercise price of $1.65 per share. The Company was required to treat the warrant as a liability pending approval of its shareholders at the Company's 2008 annual meeting of shareholders to provide shares of common stock issuable to Alta upon exercise of the warrant. Accordingly, the fair value of the warrant was recorded as a liability on the date of issuance and marked-to-market at each quarter-end. This resulted in a $1.5 million credit to other income recorded in the first quarter of 2008. At the annual meeting of shareholders in May 2008, we received shareholder approval to issue shares of our common stock upon exercise of the warrant. Consequently, the warrant liability was marked-to-market through the date of shareholder approval and the remaining liability was credited to additional paid-in capital. Since 2005 we have recorded non-operating other income for the change in fair value of the Convertible Senior Notes derivative liability. See Note 7 of "Notes to Consolidated Financial Statements" in this Form 10-Q for more information regarding the Notes derivative liability.
Net other income also includes net foreign currency transaction gains and losses, including unrealized foreign currency gains and losses related to short-term intercompany balances with our foreign subsidiaries. These gains and losses have increased in 2008 and 2009 due to larger fluctuations in foreign currency exchange rates.
Income Taxes. In the first quarters of both 2009 and 2008, we recognized $0.1 million of income tax expense related to (1) deferred income taxes connected with the deductibility of goodwill from the CryoCath acquisition for tax purposes, but not for book purposes, and the uncertainty of the timing of its reversal for book purposes and (2) current income taxes for our Austrian subsidiary. In future years, we will continue recognizing deferred income tax expense related to this goodwill over its tax life as long as there is no impairment of the goodwill's recorded value.
Through 2008 we have accumulated approximately $161 million of net operating loss ("NOL") carryforwards for U.S. tax purposes ($57 million related to 3F). We believe our ability to fully utilize the existing NOL carryforwards could be restricted on a portion of the NOL by changes in control that may have occurred or may occur in the future and by our ability to generate net income.


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We are conducting a formal study of whether, or to what extent, past changes in control of ATS impairs our NOL carryforwards. We have recorded no net deferred tax asset related to our NOL carryforwards and other deferred items as we currently cannot determine that it is more likely than not that this asset will be realized and we, therefore, have provided a valuation allowance for the entire asset.
Net Loss. Our changes in net losses in the first quarter of 2009 compared to the same period in 2008 were due to higher sales and gross profit, partially offset by slightly higher operating expenses and significantly lower non-operating income, all of which are described in detail above. Liquidity and Capital Resources
Cash, cash equivalents, and short-term investments totaled $17.4 million and $20.9 million at April 4, 2009 and December 31, 2008, respectively. Operating Activities. During the first quarter of 2009, we received cash payments from customers of approximately $17.7 million and made payments to employees and suppliers of approximately $19.2 million. During the first quarter of 2008, we received cash payments from customers of approximately $14.6 million and made payments to employees and suppliers of approximately $16.0 million. Since 2002, we have incurred significant expenses to support the . . .

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