Scott Ullem: Yeah. It’s Scott, let’s hold-off on that question about share and the environment, new product introductions and all kind of stuff. There’s a lot that we expect to happen in 2024. And we’ll look forward to getting into all of those details and forecasts when we get together at our investor conference in December.
Travis Steed: Okay. Great. Thanks a lot.
Operator: Our next question comes from Joanne Wuensch with Citibank. Please state your question.
Joanne Wuensch: Good afternoon, and thank you for taking the questions. Two of them. I know you don’t want to talk about 2024, but last year, you did a great job of with helping to understand the impact of FX on gross margins. And it sounds like you’re going to have that FX headwind next year. Can you sort of level set us for how to think about gross margins next year?
Scott Ullem: Yeah, I hate to do this to you, Joanne. But again, we’re going to have to hold off until we get to December. Really, all we can say right now is that, we think we’re going to see some pressure on the top line reported sales dollars won’t impact our underlying growth rates. And the reported sales dollars headwind is going to flow right down to earnings per share. Now again, that’s not current foreign exchange rate. So when we get to December and we lay out our full year guidance for 2024, and we’ll go through all the lines of the P&L and take you through all the details. But at this point we really can’t tell you more.
Joanne Wuensch: Okay. My follow-up question, which is completely unrelated, if you did have another quarter of double-digit surgical valve revenue. And I’m curious what’s helping to drive that and how much of it is maybe an upcharge from RESILIA versus underlying demand? Thank you.
Bernard Zovighian: Yes. So let me start here, so 11% obviously, we are very pleased, I don’t know if you remember, but a few years ago, nobody believed in surgical and we believe in surgical because we have been a pioneer here. We have been a great innovator and our innovation is paying off. What we see in Q3 again, like in 2023, we see a balanced combination between adoption of our RESILIA platform, premium pricing, and also the procedural growth. So altogether, but it is very balanced between procedure growth and our premium technology.
Daveen Chopra: Yeah, I’ll just add. It’s, we’ll try to bring this to life a little bit at the investor conference is, I almost feel like when we have a good surgical quarter that you guys get mad at us because you think it comes at the expense of TAVR. And I’ll tell you as the guy that runs both those business units, that gets really frustrating after a while, and my new GM is really mad about it. So as — but what you have to understand is our surgical business isn’t 100% aortic stenosis. Our surgical business treats aortic, we treat mitral. And even in the aortic space, we don’t just treat aortic stenosis, we treat aortic regurgitation. We have products like KONECT, where we’re treating aortic aneurysm disease. We have repair products, replacement products. So there’s just a lot more that goes into that business than aortic stenosis. So thinking that the zero sum game between the two businesses just isn’t the right way to think about it.
Operator: Thank you. Our next question comes from Matt Miksic with Barclays. Please state your question.
Matt Miksic: Hey, thanks. Thanks for taking the questions. So one, if I could on — sometimes Scott and Bernard, you’re able to offer some color as to what, how the different types of centers in the U.S. have been performing. You mentioned staffing stable. Any color as to, which large, small or size centers were additive to growth in what ways? And then I have one follow up.
Bernard Zovighian: Yeah, maybe, I’m going to ask Larry to comment on that with.
Larry Wood: Yeah. We look at this every quarter, and I will just tell you just even internally amongst us. We sort of see the growth rates by segment, and then we sort of make up the reasons for why we think they’re different a little bit. I will tell you, during COVID, we saw trends that said when COVID spiked, people tended to stay a little bit closer to home, and we saw maybe some of our smaller centers grow more and, and larger centers would grow less. And then as COVID wane we’d, we’d see larger centers kind of return to higher growth. I think this quarter, we probably saw a little bit more growth in the higher — in the bigger centers than the smaller centers. But really, I think it’s getting a little bit negligible over kind of returning to a little bit of a sense of normalcy as it relates to growth across center size.
Matt Miksic: That’s helpful. Thank you for that. And then, and then just one follow-up on just maybe a segment of the market that’s, like, got to be getting bigger, I guess at this point. But looking forward being the only valve on the market with a valve-in-valve indication. How big is that now and how important is that? We talk a little bit about the expanding indications into, not asymptomatic and moderate AS patients over the intermediate long-term. But, does valve-in-valve become a factor that you can talk more about or maybe help us understand how that factors into your growth or the general growth in the market at this point?
Larry Wood: Yeah. I think — it’s a good question. I think valve-in-valve isn’t, isn’t a huge part of our offering right now. It’s not a big driver for us. We do TAVR and SAVR, so TAVR in failed bioprological surgical valves. And as TAVR came online, we saw more and more biological valve usage in younger patients because they knew they would have this TAVR option down the road. So we think that, that’s going to be, as these patients live longer, obviously, our surgical valves are very durable, but that was a whole basis for INSPIRIS, was creating a valve that would be a great platform for their TAVR procedure down the road, and that’s the whole basis for it, and we think that will pay dividends later. As we just got the low risk approval, it’s still fairly new for us.
It’s not something that’s been around for, forever. But the more and more patients that are younger that are getting TAVR, eventually, those patients will come back and need a second procedure. And so for us, having a tab and tab option, it just feeds directly into our lifetime management strategy, which is putting in a first valve and ensuring that you have a strategy for that next intervention. And that’s true, whether it’s in INSPIRIS as your first valve or whether it’s a SAPIEN 3 as your first valve, we want to make sure we have an option for that patient when they come back. And that’s what’s great about both of our surgical and TAVR platforms is they’re both really a great host for that future valves. And we do think, as you advance down the road, the tab and tab will become a bigger contributor to our growth over time.
