美敦力 (MDT) 2024 Q3 法說會逐字稿

Good morning, and welcome to Minnesota, where we finally have some snow. I'm Ryan Weispfenning, Vice President and Head of Medtronic Investor Relations. And I appreciate that you're joining us this morning for our fiscal '24 third quarter video earnings webcast.

早安，歡迎來到明尼蘇達，我們終於下雪了。我是瑞安‧韋斯芬寧 (Ryan Weispfenning)，美敦力 (Medtronic) 副總裁兼投資者關係主管。我很感謝您今天早上加入我們的 24 財年第三季視訊收益網路廣播。

Before we go inside to hear our prepared remarks, I'll share a few details about today's webcast. Joining me are Geoff Martha, Medtronic Chairman and Chief Executive Officer; and Karen Parkhill, Medtronic Chief Financial Officer. Geoff and Karen will provide comments on the results of our third quarter, which ended on January 26, 2024, and our outlook for the remainder of the fiscal year. After our prepared remarks, the executive VPs covering our segments will join us, and we'll take questions from the sell-side analysts that cover the company. Today's program should last about an hour.

在我們進去聽取準備好的發言之前，我將分享有關今天網路廣播的一些細節。與我一起出席的還有美敦力 (Medtronic) 董事長兼執行長 Geoff Martha；和美敦力財務長 Karen Parkhill。 Geoff 和 Karen 將對我們截至 2024 年 1 月 26 日的第三季業績以及我們對本財年剩餘時間的展望發表評論。在我們準備好的發言之後，負責我們各部門的執行副總裁將加入我們，我們將回答負責該公司的賣方分析師的問題。今天的節目應該持續大約一個小時。

Earlier this morning, we issued a press release containing our financial statements and divisional and geographic revenue summaries. We also posted an earnings presentation that provides additional details on our performance. The presentation can be accessed in our earnings press release or on our website at investorrelations.medtronic.com.

今天早些時候，我們發布了一份新聞稿，其中包含我們的財務報表以及部門和地區收入摘要。我們還發布了一份收益報告，提供了有關我們業績的更多詳細資訊。您可以在我們的收益新聞稿或我們的網站 Investorrelations.medtronic.com 上存取該簡報。

During today's program, many of the statements we make may be considered forward-looking statements and actual results may differ materially from those projected in any forward-looking statements. Additional information concerning factors that could cause actual results to differ is contained in our periodic reports and other filings that we make with the SEC and we do not undertake to update any forward-looking statement.

在今天的節目中，我們所做的許多陳述可能被視為前瞻性陳述，實際結果可能與任何前瞻性陳述中預測的結果有重大差異。有關可能導致實際結果出現差異的因素的更多資​​訊包含在我們向 SEC 提交的定期報告和其他文件中，我們不承諾更新任何前瞻性聲明。

Unless we say otherwise, all comparisons are on a year-over-year basis and revenue comparisons are made on an organic basis, which excludes the impact of foreign currency and third quarter revenue in the current and prior year reported as other, which stems from prior business separations. There were no acquisitions made in the last 4 quarters that had a significant impact on total company or individual segment quarterly revenue growth.

除非我們另有說明，否則所有比較都是按年比較，收入比較是在有機基礎上進行的，不包括外幣和本年度和上一年報告為其他的第三季度收入的影響，這源於之前的業務分離。過去 4 個季度沒有發生對公司整體或個別部門季度收入成長產生重大影響的收購。

References to sequential revenue changes compared to the second quarter of fiscal '24 and are made on an as-reported basis. And all references to share gains or losses, referred to revenue share in the fourth calendar quarter of 2023 compared to the fourth calendar quarter of 2022, unless otherwise stated.

與 2024 財年第二季相比，收入連續變化的參考資料是按報告的基礎進行的。除非另有說明，否則所有提及份額收益或損失的內容均指 2023 年第四季與 2022 年第四季相比的收入份額。

Reconciliations of all non-GAAP financial measures can be found in our earnings press release or on our website at investorrelations.medtronic.com. And finally, our EPS guidance does not include any charges or gains that would be reported as non-GAAP adjustments to earnings during the fiscal year.

所有非 GAAP 財務指標的調整表可在我們的收益新聞稿或我們的網站 Investorrelations.medtronic.com 上找到。最後，我們的每股盈餘指引不包括本財政年度收益的非公認會計原則調整報告的任何費用或收益。

With that, let's head into the studio and hear about the quarter.

接下來，讓我們走進工作室，了解本季的情況。

(presentation)

（推介會）

Hi, everyone, and thank you for joining us today. Our momentum and solid execution continued this quarter as we establish a track record of consistently delivering mid-single-digit organic revenue growth. Diabetes took another step forward with double-digit growth supported by a return to growth in the U.S. I'd also note the particular strength we saw in multiple businesses like Core Spine, Cardiac Surgery, Structural Heart and Cardiac Pacing. And we had strong growth across international markets as we expand access to our innovative health care technologies all around the globe.

大家好，感謝您今天加入我們。本季我們持續保持動能和穩健的執行力，建立了持續實現中個位數有機收入成長的記錄。在美國恢復成長的支持下，糖尿病業務又向前邁出了兩位數的成長。我還要指出的是，我們在核心脊椎、心臟外科、結構性心臟和心臟起搏等多個業務中看到了特別的優勢。隨著我們在全球擴大創新醫療保健技術的使用範圍，我們在國際市場上實現了強勁成長。

At the same time, we've had a rapid cadence of new product approvals, and we're continuing to differentially invest in our pipeline of highest growth opportunities. We're advancing innovative core technologies like robotics, AI and closed-loop systems. And with 5 AI products already FDA approved, we're leading the way in bringing the tech into med tech.

同時，我們的新產品審批節奏很快，我們將繼續對最高成長機會的管道進行差異化投資。我們正在推動機器人、人工智慧和閉環系統等創新核心技術。憑藉 5 種人工智慧產品已獲得 FDA 批准，我們在將該技術引入醫療技術方面處於領先地位。

We also continue to make progress on our comprehensive transformation of the company. We're incorporating a performance-driven culture that's based on execution, speed and playing to win. And we're leveraging our scale to drive efficiencies. So when you look at our financials this quarter, you're seeing the early results of our focus on restoring earnings power and converting our earnings into strong cash flow. And we're using that cash to both invest in high-return opportunities and return value to our shareholders.

我們公司的全面轉型也不斷取得進展。我們正在融入一種以執行力、速度和贏球為基礎的績效驅動文化。我們正在利用我們的規模來提高效率。因此，當您查看我們本季的財務數據時，您會看到我們專注於恢復盈利能力並將盈利轉化為強勁現金流的早期結果。我們利用這些現金來投資高回報機會並為股東回報價值。

So we're executing and we're delivering. And we expect to continue over the coming quarters and years, given our momentum, our ongoing transformation, our breakthrough innovation, our exposure to strong secular growth markets and our numerous catalysts across the business.

所以我們正在執行並交付。考慮到我們的勢頭、持續的轉型、突破性的創新、我們對強勁長期增長市場的接觸以及我們在整個業務中的眾多催化劑，我們預計在未來幾個季度和幾年裡繼續保持這一勢頭。

Now before I get into the details of our Q3 results, I do want to mention that we provided a portfolio management update this morning on our Patient Monitoring and Respiratory Interventions businesses. After a comprehensive review, we have decided to exit our unprofitable ventilator product line and retain and bring together our remaining PMRI businesses into one business, which we're calling Acute Care and Monitoring.

現在，在詳細介紹第三季業績之前，我確實想提一下，我們今天早上提供了有關患者監測和呼吸幹預業務的投資組合管理更新。經過全面審查後，我們決定退出不盈利的呼吸機產品線，保留剩餘的 PMRI 業務並將其合併為一項業務，我們稱之為急性護理和監測。

Now we've determined it is in the best interest of Medtronic, it's stakeholders, the ACM business, both near and long term to exit vents because of its increasing on profitability and market preference shift to lower acuity ventilators.

現在我們已經確定，從短期和長期來看，出口通風口都符合美敦力、其利益相關者、ACM 業務的最佳利益，因為其盈利能力不斷提高，而且市場偏好轉向較低敏銳度的呼吸機。

Now as we exit vents, I want to recognize the strong legacy of our business and the Puritan Bennett brand. And we're committed to serving the needs of our customers and honoring our ventilator service contracts. And I also want to thank the employees in our ventilator business who played an incredible role during the pandemic to dramatically expand production to get ventilators to the communities around the world that needed them. And while we exit, we do believe that existing manufacturers can meet the customer demand for new ventilators going forward.

現在，當我們退出通風口時，我想認識到我們的業務和 Puritan Bennett 品牌的強大遺產。我們致力於滿足客戶的需求並履行我們的呼吸器服務合約。我還要感謝我們呼吸機業務的員工，他們在大流行期間發揮了令人難以置信的作用，大幅擴大了產量，以便將呼吸機送到世界各地有需要的社區。雖然我們退出，但我們確實相信現有製造商能夠滿足客戶未來對新型呼吸器的需求。

Now, at the same time, we decided to retain and refocus the remaining PMRI businesses. Three main factors have driven this decision. First, we have strong conviction in our ability to lead and drive growth in Acute Care and Monitoring given our improved competitive position and our ability to properly fund this business with savings from exiting vents.

現在，我們同時決定保留並重新聚焦剩餘的 PMRI 業務。三個主要因素推動了這個決定。首先，鑑於我們競爭地位的提高以及我們有能力利用現有通風口的節省為這項業務提供適當的資金，我們堅信我們有能力領導和推動急診和監測領域的成長。

Second, the importance of data in this space is changing rapidly. It's becoming the basis of innovation. And this fact further improves our competitive differentiation.

其次，數據在這個領域的重要性正在快速改變。它正在成為創新的基礎。這一事實進一步提高了我們的競爭優勢。

And lastly, as a company more broadly, we continue to prioritize profitable innovation-driven growth and category leadership and ACM can deliver both. That does not mean we will shy away from additional portfolio moves going forward, but the bar is high for any strategic activity that dilutes our focus on our profit and growth.

最後，作為一家更廣泛的公司，我們繼續優先考慮可獲利的創新驅動型成長和品類領導力，而 ACM 可以實現這兩點。這並不意味著我們將迴避未來的額外投資組合舉措，但對於任何削弱我們對利潤和成長的關注的策略活動來說，門檻都很高。

So when you take these decisions together, we're able to provide increased investment for Acute Care and Monitoring using the savings from vents and bringing 2 businesses together, all without creating dilution to our P&L.

因此，當您共同做出這些決定時，我們能夠利用通風口節省的資金並將兩家企業合併在一起，為急性護理和監測提供更多投資，而不會稀釋我們的損益。

Now let's get into the details behind our Q3 results. We continue to look at our portfolio in 3 categories: Established market leaders, synergistic and highest growth businesses. In this quarter, all 3 grew in line with our expected growth algorithm. Our established market leader and synergistic businesses grew mid-single digits, while our highest growth businesses posted high single-digit growth, and we expect their contribution to our overall growth to further accelerate in the quarters ahead.

現在讓我們詳細了解第三季業績背後的細節。我們繼續將我們的投資組合分為三類：成熟的市場領導者、協同和成長最快的業務。在本季度，這三個因素的成長都符合我們預期的成長演算法。我們既定的市場領導者和協同業務實現了中個位數成長，而我們成長最快的業務則實現了高個位數成長，我們預計它們對我們整體成長的貢獻將在未來幾季進一步加速。

Now looking first at the established market leaders. Combined, they made up just under half of our revenue and grew 4%.

現在首先關注已確立的市場領導者。它們合計占我們收入的一半以下，並且成長了 4%。

Starting with Cranial & Spinal Technologies. We're driving consistent above-market growth on the continued adoption of our AiBLE ecosystem. CST delivered high single-digit growth in Core Spine, mid-teens growth in Biologics and high single-digit growth in Enabling Technology. We had strong double-digit unit growth in StealthStation navigation, O-arm imaging and Mazor Robotics systems, a leading indicator for future growth in this business. We also continue to see strong adoption of unit adaptive spine intelligence, our integrated AI-based surgical planning solution.

從顱骨和脊椎技術開始。透過持續採用 AiBLE 生態系統，我們正在推動持續高於市場的成長。 CST 在 Core Spine 領域實現了高個位數成長，在生物製劑領域實現了中位數成長，在支援技術領域實現了高個位數成長。我們在 StealthStation 導航、O 型臂成像和 Mazor 機器人系統方面實現了強勁的兩位數單位成長，這是該業務未來成長的領先指標。我們也繼續看到單位自適應脊椎智慧的廣泛採用，這是我們基於人工智慧的整合手術規劃解決方案。

Now with AiBLE, we're offering a complete robust ecosystem of enabling technologies and associated implants for spine surgeons. Our global footprint, which includes over 10,000 systems is over 4x greater than the nearest competitor. And with this scale and extensive and rapidly increasing installed base, we're transforming the spine industry. We are leading the way. As more surgeons adopt our integrated spine technologies and in an environment where there is disruption from consolidation, we're attracting the best sales teams to Medtronic to grow and expand our business.

現在，透過 AiBLE，我們為脊椎外科醫生提供了一個完整、強大的支持技術和相關植入物的生態系統。我們的全球覆蓋範圍包括 10,000 多個系統，是最接近的競爭對手的 4 倍以上。憑藉如此規模和廣泛且快速增長的安裝基礎，我們正在改變脊椎行業。我們正在引領潮流。隨著越來越多的外科醫生採用我們的整合脊椎技術，並且在整合帶來幹擾的環境中，我們正在吸引最優秀的銷售團隊來到美敦力，以發展和擴大我們的業務。

Next, in surgical, we grew 3%. Our Wound Management business, 1 share, growing in the high teens on the strength of our V-Loc barbed sutures. We also had solid mid-single-digit growth in Hernia products as we won share in synthetic permanent mesh with our ProGrip platform. And as expected, our surgical growth continue to have a modest impact from declines in bariatric surgery.

接下來，在外科領域，我們成長了 3%。我們的傷口管理業務，1股，憑藉我們的V-Loc有刺縫合線的優勢，以十幾歲的速度增長。由於我們透過 ProGrip 平台贏得了合成永久網片的份額，我們的疝氣產品也實現了穩定的中個位數成長。正如預期的那樣，我們的手術增長繼續受到減肥手術減少的適度影響。

Now we still believe this impact will be temporary as more patients become eligible for surgery, and as patients seek a more permanent treatment to weight loss.

現在，我們仍然相信，隨著越來越多的患者有資格接受手術，並且患者尋求更持久的減肥治療，這種影響將是暫時的。

To wrap up our established market leaders, cardiac rhythm also grew 3%, driven by high single-digit growth in cardiac pacing. Our Micra leadless pacemakers continued to post strong results, growing 15%, driven by the launch of our next-generation Micra AV2 and VR2 devices. We're also benefiting from the adoption of conduction system pacing, an alternative to traditional single or dual chamber pacing. Our 3830 lead, the only one on the market approved for conduction system pacing, continue to grow strong double digits.

為了總結我們既定的市場領導者，在心臟起搏高個位數成長的推動下，心律也增加了 3%。在新一代 Micra AV2 和 VR2 設備推出的推動下，我們的 Micra 無引線起搏器繼續取得強勁業績，成長了 15%。我們也受益於傳導系統起搏的採用，這是傳統單腔或雙腔起搏的替代方案。我們的 3830 主導產品是市場上唯一獲準用於傳導系統起搏的產品，持續以兩位數的速度強勁成長。

In CRM, we also began training and a limited launch of our AURORA EV-ICD. Now we expect the EV-ICD to reaccelerate our defibrillation solutions growth in the coming quarters. As I've shared with you in the past, AURORA is a game changer in the ICD space. It delivers the benefits of a traditional ICD including similar size, longevity, and pacing features, but without the leads in the harder veins. And these benefits can be realized with one device and only one implant procedure.

在 CRM 方面，我們也開始培訓並有限推出 AURORA EV-ICD。現在，我們預計 EV-ICD 將在未來幾季重新加速我們的除顫解決方案的成長。正如我過去與您分享的那樣，AURORA 是 ICD 領域的遊戲規則改變者。它具有傳統 ICD 的優點，包括相似的尺寸、壽命和起搏功能，但沒有較硬靜脈中的引線。只需使用一台設備和一次植牙手術即可實現這些優勢。

We expect our advantages will not only displace the competitors device, we will expand the population far beyond the existing segment and be a strong growth driver for CRM.

我們預計我們的優勢不僅會取代競爭對手的設備，而且還將擴大人口範圍，遠遠超出現有細分市場，並成為 CRM 的強勁成長動力。

Now turning to our synergistic businesses. Combined, they grew mid-single digits in Q3, and I'll highlight some of the drivers here. Let's start with Aortic, which grew 13% on supply recovery and continued momentum of our Endurant AAA franchise. Cardiac Surgery grew 10%, driven by strength in perfusion and cannula and ECLS oxygenators given competitor quality issues and the strong sales in international markets of our Avalus surgical valve.

現在轉向我們的協同業務。總的來說，它們在第三季度實現了中個位數的成長，我將在這裡重點介紹一些驅動因素。讓我們從 Aortic 開始，由於供應恢復和我們的 Endurant AAA 特許經營權的持續增長勢頭，該公司增長了 13%。鑑於競爭對手的品質問題以及我們的 Avalus 手術瓣膜在國際市場上的強勁銷售，心臟外科業務增長了 10%，這得益於灌注、插管和 ECLS 氧合器的實力。

Coronary grew 7%, driven by double-digit growth in both guide catheters and balloons. And we increased our drug-eluting stent share in the U.S. and in Europe on the continued rollout of our Onyx Frontier drug-eluting stent.

在引導導管和球囊兩位數增長的推動下，冠狀動脈增加了 7%。隨著我們繼續推出 Onyx Frontier 藥物洗脫支架，我們增加了在美國和歐洲的藥物洗脫支架份額。

Now turning to businesses in our highest growth markets. As I mentioned earlier, together, these businesses grew in the high single digits this quarter, and we expect their contribution to our growth to accelerate going forward. Now Diabetes led the way, growing double digits on the global adoption of our game-changing MiniMed 780G system. We're seeing strong sequential momentum, growing 5% over the prior quarter.

現在轉向我們成長最快的市場中的企業。正如我之前提到的，這些業務本季以高個位數成長，我們預計它們對我們未來成長的貢獻將加速。現在，糖尿病領域一馬當先，我們改變遊戲規則的 MiniMed 780G 系統的全球採用率成長了兩位數。我們看到強勁的環比勢頭，比上一季增長 5%。

Our customer base is growing sequentially, and we're driving more revenue per customer.

我們的客戶群不斷成長，我們正在為每位客戶帶來更多收入。

In the U.S., we not only returned to growth, we grew mid-single digits, driven by nearly 50% revenue growth in insulin pumps. We doubled our new users year-over-year, attracting those on multiple daily injections as well as users of competitor systems. Users are choosing 780G for the outcomes it delivers. With intensive insulin users, these outcomes matter. And the 780G is highly differentiated. It's the only AID system to automatically adjust and correct sugars every 5 minutes. It offers flexible glucose targets as low as 100 and features our proprietary meal detection technology.

在美國，我們不僅恢復了成長，而且在胰島素幫浦收入成長近 50% 的推動下實現了中個位數成長。我們的新用戶數量逐年增加了一倍，吸引了每天多次注射的用戶以及競爭對手系統的用戶。使用者選擇 780G 是因為它提供的結果。對於大量胰島素使用者來說，這些結果很重要。而且780G差異化很大。它是唯一每 5 分鐘自動調整和糾正糖分的 AID 系統。它提供低至 100 的靈活葡萄糖目標，並採用我們專有的膳食檢測技術。

This leads to high time and range for users. And this type of glycemic control is coming with less effort and burden. As users realize the relief that comes from spending more time in automation with our SmartGuard technology. It's worth pointing out that in a recent third-party survey of nearly 2,000 U.S. diabetes pump users, the 780G scored #1 in overall pump satisfaction. And among Type 1 CGM users, our Guardian 4 Sensor mirrored competitor sensors in overall satisfaction.

這為用戶帶來了很高的時間和範圍。而且這種血糖控制方式的努力和負擔更少。當使用者意識到使用我們的 SmartGuard 技術在自動化上花費更多時間可以減輕負擔。值得指出的是，在最近對近 2,000 名美國糖尿病泵用戶進行的第三方調查中，780G 在泵浦整體滿意度方面排名第一。在 1 型 CGM 用戶中，我們的 Guardian 4 感測器的整體滿意度與競爭對手的感測器相當。

And during the quarter, we secured CE Mark for our Simplera Sync sensor for use with the 780G, and we look to begin the limited release this spring. And in the U.S., we're planning to submit the 780G with Simplera Sync to the FDA in the first half of this calendar year. Simplera Sync is half the size of our current sensor. It has a disposable design and is much easier to put on.

在本季度，我們為與 780G 配合使用的 Simplera Sync 感測器獲得了 CE 標誌，我們希望在今年春天開始限量發布。在美國，我們計劃在今年上半年向 FDA 提交帶有 Simplera Sync 的 780G。 Simplera Sync 的尺寸是我們目前感測器的一半。它採用一次性設計，更容易佩戴。

Now we've been driving the Diabetes turnaround for some time. And I got to tell you, it certainly feels really good to return to double-digit growth, but we're not finished here. There is definitely more work to be done as we work to bring to market an even more robust ecosystem of differentiated technology for people living with diabetes including, next-generation durable pumps, smart pens, patch pumps, sensors and algorithms. And as the intensive insulin management space moves to using smart dosing through either AID or Smart MDI, we expect an acceleration in the growth contribution from our Diabetes business.

現在，我們推動糖尿病的轉變已經有一段時間了。我必須告訴你，恢復兩位數成長的感覺確實很好，但我們還沒結束。我們肯定還有更多的工作要做，因為我們致力於為糖尿病患者推出更強大的差異化技術生態系統，包括下一代耐用泵、智慧筆、貼片泵、感測器和演算法。隨著強化胰島素管理領域轉向透過 AID 或智慧 MDI 使用智慧劑量，我們預期糖尿病業務的成長貢獻將加速。

Now turning to Cardiac Ablation Solutions. We delivered 11% growth in international markets, including 9% growth in Western Europe. Our strong international growth as well as our overall performance continues to be driven by our leading Arctic Front cryo solution as Pulse Field Ablation is still in the early stages. We're seeing, though, a lot of enthusiasm in the market for our PFA products.

現在轉向心臟消融解決方案。我們在國際市場實現了 11% 的成長，其中西歐成長了 9%。由於脈衝場消融仍處於早期階段，我們領先的 Arctic Front 冷凍解決方案繼續推動我們強勁的國際成長和整體業績。不過，我們看到市場對我們的 PFA 產品表現出極大的熱情。

In Europe, we're the only company with PFA offerings for both the single shot and the focal segments. And in single shot, we have now started the limited market release of our PulseSelect PFA system here in fiscal Q4. And we're seeing very efficient procedures and after just a couple of cases. And so the learning curve is really short. The catheter handling and maneuverability has been excellent due to its small shaft and our custom 10 French bidirectional sheath. Clinicians are also reporting no noticeable muscle contraction with our PFA product, which is beneficial for patient experience.

在歐洲，我們是唯一一家同時為單鏡頭和對焦部分提供 PFA 產品的公司。現在，我們已經在第四財季開始在有限的市場上發布 PulseSelect PFA 系統。經過幾個案例後，我們看到了非常有效的程序。所以學習曲線真的很短。由於其小軸和我們定制的 10 French 雙向護套，導管操作和可操作性非常出色。臨床醫生也報告說，我們的 PFA 產品沒有明顯的肌肉收縮，這有利於患者體驗。

In focal, we continue to ramp manufacturing of the Affera mapping system and Sphere9 catheter and remain in limited market release in Europe. Sphere9 is the only catheter that can perform both pulse field ablation and radio frequency ablation and high-density mapping. It's really an all-in-one catheter.

重點是，我們繼續提高 Affera 測繪系統和 Sphere9 導管的生產，並在歐洲保持有限的市場投放。 Sphere9 是唯一可以同時進行脈衝場消融、射頻消融和高密度標測的導管。它確實是一種一體化導管。

In the U.S., our cast business declined in the quarter. We faced the first full quarter of competition in the cryoablation space, which is a space we created and had been the only player. In addition, many customers actually held back purchases as they awaited the launch of our PulseSelect PFA catheter, which is now commercially available.

在美國，我們的鑄造業務本季有所下降。我們在冷凍消融領域面臨第一個完整季度的競爭，這是我們創建的一個領域，也是唯一的參與者。此外，許多客戶實際上推遲了購買，因為他們等待我們的 PulseSelect PFA 導管的推出，該導管現已上市。

We do expect to improve from here as we roll out the recently approved next-generation Nitron CryoConsole and PulseSelect, the only PFA catheter FDA-approved for both paroxysmal and persistent AF. And in addition to the European feedback, clinicians have consistently commented on how well it's visualized and how easily it connects to their mapping system.

隨著我們推出最近批准的下一代 Nitron CryoConsole 和 PulseSelect，我們確實希望從這裡開始改進，這是唯一經 FDA 批准用於陣發性和持續性 AF 的 PFA 導管。除了歐洲的回饋之外，臨床醫生也一直對它的視覺化程度以及它與地圖系統連接的容易程度發表評論。

So we're also making progress in bringing our Affera mapping system and Sphere9 catheter to the U.S. with the last patient follow-up in our Sphere Per-AF pivotal trial now completed. We expect to see the results at a medical meeting in the first half of this calendar year.

因此，我們在將 Affera 測繪系統和 Sphere9 導管引入美國方面也取得了進展，我們的 Sphere Per-AF 關鍵試驗的最後一位患者隨訪現已完成。我們預計將在今年上半年的醫學會議上看到結果。

With an $8 billion market size, expanding our share in this under-penetrated cardiac ablation space is a big opportunity for us. We expect our growth profile to improve over time, first, moving towards market growth and then winning share as we bring our rich pipeline of innovation to patients who need this technology.

市場規模達 80 億美元，擴大我們在這個滲透不足的心臟消融領域的份額對我們來說是一個巨大的機會。我們預計我們的成長狀況將隨著時間的推移而改善，首先，實現市場成長，然後透過為需要這項技術的患者提供豐富的創新管道來贏得份額。

In Neurovascular this quarter, we grew high single digits when you exclude sales in China where the market is subject to volume-based procurement. We continue to have strong double-digit growth in flow diversion globally. This is being driven by our innovative Shield Technology for treating brain aneurysms, which is available on both Pipeline Flex and Vantage flow diverters.

本季在神經血管領域，如果排除中國市場的銷售額，我們的銷售額將實現高個位數成長，因為該市場實行基於數量的採購。全球流量轉移持續保持兩位數的強勁成長。這是由我們用於治療腦動脈瘤的創新 Shield 技術推動的，該技術適用於 Pipeline Flex 和 Vantage 分流器。

In Robotic Surgical Technologies, we continued growing the installed base for our differentiated Hugo robotic system in international markets. In the U.S., our EXPAND URO pivotal trial continues to enroll, and we expect to have first enrollment in our hernia trial very soon.

在機器人手術技術領域，我們繼續擴大我們差異化的 Hugo 機器人系統在國際市場上的安裝基礎。在美國，我們的 EXPAND URO 關鍵試驗繼續入組，我們預計很快就會首次入組疝氣試驗。

We expect Hugo, equipped with advanced digital capabilities, to be a meaningful growth driver for us in the years ahead. We believe surgeon preference for our open console and modular design, our leading position in minimally invasive surgery and instrumentation, our connected digital ecosystem and data-enabled insights, along with our world-class surgical training program and partnerships, will meaningfully advance the low penetration of robotic surgery around the world.

我們預計，配備先進數位功能的 Hugo 將在未來幾年成為我們有意義的成長動力。我們相信，外科醫生對我們的開放式控制台和模組化設計的偏好、我們在微創手術和器械方面的領先地位、我們互聯的數位生態系統和數據支援的見解，以及我們世界一流的手術培訓計劃和合作夥伴關係，將有意義地推動低滲透率的發展世界各地的機器人手術。

Now turning to Structural Heart. We grew high single digits in the quarter, including mid-single digits sequentially as we see ongoing adoption of Evolut FX and its improved design and market-leading valve performance.

現在轉向結構心臟。由於我們看到 Evolut FX 的持續採用及其改進的設計和市場領先的閥門性能，我們在本季度實現了高個位數成長，其中包括中個位數成長。

In Europe, where FX was launched for the first full quarter, we grew double digits. And Japan grew in the low 20s on the continued adoption of FX. I'm pleased to share the news today that we have submitted Evolut FX plus to the FDA for approval. FX Plus has 3 windows in the frame to allow easy coronary access while providing the same dependable valve performance of our Evolut platform.

在歐洲，外匯在第一個完整季度推出，我們實現了兩位數的成長。日本由於繼續採用外匯而實現了 20 多歲的增長。我今天很高興分享這個消息，我們已向 FDA 提交 Evolut FX plus 批准。 FX Plus 框架上有 3 個窗口，可輕鬆進入冠狀動脈，同時提供與我們的 Evolut 平台相同可靠的瓣膜性能。

And we were also pleased to hear that 1-year trial results of our SMART trial will be presented as a late breaker at ACC on April 7. We're excited to see the results and are looking forward to having both FX plus and the SMART trial as well as the continued strength of our 4-year low-risk data as catalysts for our Structural Heart business.

我們也很高興得知我們的 SMART 試驗的 1 年試驗結果將於 4 月 7 日在 ACC 上作為遲到的突破者公佈。我們很高興看到結果，並期待 FX plus 和 SMART試驗以及我們4 年低風險數據的持續強勁作為我們結構心臟業務的催化劑。

Now with that, let's go to Karen for a deeper look at our Q3 financial performance and our fiscal '24 guidance raise. Karen?

現在，讓我們請凱倫更深入地了解我們第三季度的財務業績和 24 財年指導方針的提高。凱倫？

So looking at our financials. Our third quarter was another quarter where we delivered on our commitments. Our revenue grew 4.6% ahead of expectations, and adjusted EPS was $1.30, $0.04 above the midpoint of our guidance range. We attribute the beat to stronger-than-expected revenue growth and gross margin, offset by $0.04 from greater-than-anticipated currency impact, primarily from the devaluation in the Argentine peso in December.

所以看看我們的財務狀況。第三季是我們兌現承諾的另一個季度。我們的營收成長 4.6%，超出預期，調整後每股收益為 1.30 美元，比我們指導範圍的中點高出 0.04 美元。我們將業績優於預期的營收成長和毛利率歸因於大於預期的貨幣影響（主要來自 12 月阿根廷比索貶值），抵銷了 0.04 美元的影響。

We're delivering durable mid-single-digit revenue growth and have now for several quarters. As Geoff mentioned, international markets were an important driver for us. Our non-U.S. developed markets grew 6%, including 8% growth in Western Europe and 7% growth in Japan. In fact, we had double-digit growth in several of our businesses across both of those regions.

我們正在實現持久的中個位數收入成長，並且已經連續幾個季度了。正如傑夫所提到的，國際市場是我們的重要驅動力。我們的非美國已開發市場成長了 6%，其中西歐成長了 8%，日本成長了 7%。事實上，我們在這兩個地區的多項業務都實現了兩位數的成長。

Emerging markets grew 10%. We had high-teens growth in the Middle East and Africa and mid-teens growth in South Asia. China grew low double digits as some of the VBP we expected there continues to be delayed. And Eastern Europe grew in the low single digits, given Russian sanctions.

新興市場成長10%。我們在中東和非洲實現了高十幾歲的成長，在南亞實現了中十幾歲的成長。由於我們預期的一些 VBP 繼續延遲，中國經濟成長兩位數。由於俄羅斯的製裁，東歐的成長率僅為低個位數。

In the U.S., we grew 2%. We have several new product approvals that are at the earliest stages of their launches and expect those launches to positively impact our U.S. growth over the next couple of quarters and beyond.

在美國，我們成長了 2%。我們有幾個新產品獲得批准，目前正處於發布的最初階段，預計這些產品的發布將對我們在未來幾季及以後的美國成長產生積極影響。

Looking down the P&L, we delivered a strong quarter. Both our adjusted gross and operating margins were ahead of expectations. Our adjusted gross margin of 66.1% improved year-over-year, overcoming a 60 basis point headwind from foreign exchange and continued elevated inflation. We attribute the favorability primarily to the delayed China VBP and lower freight costs.

從損益表來看，我們的季度表現強勁。我們調整後的毛利率和營業利益率都超乎預期。我們的調整後毛利率年增 66.1%，克服了外匯和持續高漲的通膨帶來的 60 個基點的阻力。我們將這種有利因素主要歸因於中國 VBP 的延遲和貨運成本的降低。

We also continue to see traction from our pricing efforts and an early benefit from our comprehensive COGS efficiency efforts. While our adjusted operating margin of 25.2% declined 70 basis points, it was entirely driven by currency. In fact, operating margin on a constant currency basis was up 160 basis points from improvement in gross margin and strong SG&A leverage as we continue to drive efficiencies across the enterprise.

我們也繼續看到我們的定價工作的吸引力以及我們全面的銷貨成本效率工作的早期效益。雖然我們調整後的營業利潤率為 25.2%，下降了 70 個基點，但這完全是由貨幣驅動的。事實上，隨著我們繼續提高整個企業的效率，由於毛利率的改善和強大的 SG&A 槓桿，以固定匯率計算的營業利潤率上升了 160 個基點。

Below the operating margin line, our adjusted tax rate was a little higher than anticipated, mainly due to the jurisdictional mix of profits. On the flip side, income on our investments was also a little better than expected with higher rates.

在營業利潤線以下，我們的調整後稅率略高於預期，這主要是由於利潤的司法管轄區組合所致。另一方面，隨著利率的提高，我們的投資收入也略優於預期。

It's worth noting that while our adjusted EPS was flat year-over-year, it grew 8.5% on a constant currency basis from the leverage we drove down the P&L. We also significantly improved our free cash flow and conversion in the quarter.

值得注意的是，雖然我們調整後的每股盈餘較去年同期持平，但由於我們降低了損益表的槓桿作用，以固定匯率計算，每股盈餘成長了 8.5%。本季我們也顯著改善了自由現金流和轉換率。

Now turning to guidance. Given our top and bottom line beat and continued strength in our underlying fundamentals, we're raising our full year revenue and EPS guidance. We now expect full year organic revenue growth of 4.75% to 5%. For the fourth quarter, we're expecting organic revenue growth to be in the range of 4% to 4.5%. On a comp adjusted basis, this is an acceleration from the third quarter as we continue to ramp our recent product launches.

現在轉向指導。鑑於我們的營收和利潤成長以及基本面的持續走強，我們正在提高全年營收和每股盈餘指引。我們目前預計全年有機收入將成長 4.75% 至 5%。我們預計第四季度的有機收入成長將在 4% 至 4.5% 之間。在調整後的基礎上，隨著我們持續加大近期產品的推出力度，這一數字較第三季有所加速。

With the exit of ventilators that we announced today, we are moving the associated revenue to the other segment starting in the fourth quarter. As is the case with all revenue in other, we will exclude it from our organic revenue growth and additional details can be found in our third quarter earnings presentation.

隨著我們今天宣布退出呼吸機，我們將從第四季度開始將相關收入轉移到其他部門。與其他所有收入的情況一樣，我們將其排除在我們的有機收入成長之外，更多詳細資訊可以在我們的第三季財報中找到。

Regarding currency, based on recent rates, we would see a full year revenue impact in the range of an unfavorable $15 million to a favorable $35 million, including an unfavorable impact of $70 million to $120 million in the fourth quarter.

關於貨幣，根據最近的匯率，我們將看到全年收入受到不利影響 1500 萬美元至有利 3500 萬美元，其中包括第四季度 7000 萬美元至 1.2 億美元的不利影響。

On the bottom line, with the beat in the third quarter, we're raising our full year EPS guidance by $0.04 at the midpoint to a new range of $5.19 to $5.21. I'd point out that given our durable performance, we've been able to increase this guidance by $0.15 at the midpoint from where we initially started the year. For the fourth quarter, we expect adjusted EPS of $1.44 to $1.46. And regarding currency, based on recent rates, we're seeing an unfavorable impact of 7% on full year EPS, including an unfavorable 5% impact in the fourth quarter.

總而言之，隨著第三季的好轉，我們將全年每股收益指引中位數上調了 0.04 美元，達到 5.19 美元至 5.21 美元的新區間。我想指出的是，鑑於我們的持久表現，我們已經能夠在年初的中點將該指導值提高 0.15 美元。我們預計第四季度調整後每股收益為 1.44 美元至 1.46 美元。就貨幣而言，根據最近的匯率，我們預計全年每股收益將受到 7% 的不利影響，其中包括第四季度 5% 的不利影響。

Lastly, while we'll give our fiscal year '25 guidance on our earnings call in May after we finish our planning, I want to share our early thoughts. You've seen us deliver durable revenue growth for several quarters, and we expect that to continue.

最後，雖然我們將在完成計劃後在 5 月的財報電話會議上給出 25 財年的指導，但我想分享我們的早期想法。您已經看到我們在幾個季度實現了持久的收入成長，並且我們預計這種情況將持續下去。

Down the P&L, inflation, currency and tax are currently headwinds to earnings growth. And we expect to continue to increase our investments in R&D. That said, we're very focused on driving offsets where we can and improving the earnings power of the company.

從損益表來看，通膨、貨幣和稅收目前是獲利成長的阻力。我們預計將持續增加研發投入。也就是說，我們非常注重盡可能地推動抵銷並提高公司的獲利能力。

And regarding the portfolio management decisions we announced today, while the Street's FY '25 numbers didn't yet reflect the potential separation. With today's decision, we're able to increase investment in innovation-driven growth without near-term earnings dilution or an ongoing impact to cash flow, all with a focus on optimizing long-term shareholder value.

關於我們今天宣布的投資組合管理決策，雖然華爾街的 25 財年數據尚未反映出潛在的分離。透過今天的決定，我們能夠增加對創新驅動型成長的投資，而不會稀釋短期收益或對現金流產生持續影響，所有這些都著眼於優化長期股東價值。

I want to close by expressing my sincere gratitude to all of our employees for your hard work and unwavering commitment to the Medtronic mission. Your dedication was instrumental in achieving our results this quarter and making a difference for so many people around the world. Thank you.

最後，我想對我們所有員工的辛勤工作和對美敦力使命的堅定承諾表示誠摯的謝意。您的奉獻精神對我們本季所取得的成果發揮了重要作用，並為世界各地的許多人帶來了改變。謝謝。

Geoff, turning it back to you to take it home.

傑夫，把它還給你帶回家。

Okay. Thank you. But before I wrap up, I want to note that Tom Holloran passed away last week at the age of 94. Tom provided decades of leadership to our company. First as General Counsel, then as President and as a Director on our Board for many, many years. In the early '60s, Tom was one of the instrumental people who created our Medtronic mission, together with our founder, Earl Bakken. Tom was also a significant leader in the Twin Cities and beyond and served on several company Boards. Our thoughts are with Tom's family as they celebrate his life.

好的。謝謝。但在結束之前，我想指出 Tom Holloran 於上週去世，享年 94 歲。 Tom 為我們公司提供了數十年的領導。首先擔任總法律顧問，然後擔任總裁和董事會董事多年。在 60 年代初期，Tom 與我們的創辦人 Earl Bakken 一起是創造美敦力使命的重要人物之一。湯姆也是雙城及其他地區的重要領導者，並在多家公司董事會任職。當湯姆的家人慶祝他的一生時，我們的思念與他們同在。

Now before we go to analyst questions, I'll close with a few brief concluding comments on our progress. You've seen now for several quarters in a row that we're delivering on our commitments with durable mid-single-digit revenue growth. And when you look over the last couple of quarters, we've had a rapid cadence of meaningful innovative product approvals, many of which are just getting started, including EV-ICD, both PulseSelect and Affera in PFA, inceptive for SCS, Percept RC for DBS and, of course, our new Simplera Sync sensor in Diabetes. And we can't forget Simplicity for hypertension.

現在，在我們回答分析師問題之前，我將對我們的進展做一些簡短的總結評論。現在您已經看到，我們連續幾個季度都在兌現我們的承諾，實現了持續的中個位數收入成長。回顧過去幾個季度，我們已經快速獲得了有意義的創新產品批准，其中許多才剛開始，包括 EV-ICD、PFA 中的 PulseSelect 和 Affera、SCS 的初始階段、Percept RC DBS，當然還有我們使用於糖尿病的新型Simplera Sync 感測器。我們不能忘記高血壓的簡單性。

When you combine these with our investments to enter surgical robotics, along with the strong execution we're having in businesses like Spine and Diabetes, this is what gives us confidence in our ability to continue delivering durable growth.

當您將這些與我們進入手術機器人領域的投資結合起來，以及我們在脊椎和糖尿病等業務中的強大執行力時，這讓我們對繼續實現持久增長的能力充滿信心。

At the same time, we've been sharing with you our efforts to restore the earnings power of the company. And we're seeing those efforts begin to show up in our financials. And the comprehensive transformation that we've been working on streamlining our operating model, aligning incentives, revamping our capital and portfolio management activities and instilling a performance-driven culture, well, this is also having an impact.

同時，我們一直在與大家分享我們為恢復公司獲利能力所做的努力。我們看到這些努力開始體現在我們的財務數據中。我們一直致力於簡化營運模式、調整激勵措施、改善我們的資本和投資組合管理活動以及灌輸績效驅動文化的全面轉型，這也產生了影響。

These changes take time, and we're certainly not done, but it's very encouraging to see our progress and where we stand today. And equal exciting are the catalysts that we see coming, which we believe will lead to significant advancements for patients and value creation for both health care systems around the world and our shareholders.

這些改變需要時間，我們當然還沒有完成，但看到我們的進步和今天的立場非常令人鼓舞。同樣令人興奮的是我們看到的催化劑，我們相信這將為患者帶來重大進步，並為世界各地的醫療保健系統和我們的股東創造價值。

So with that, let's move to Q&A, where we're going to try to get to as many analysts as possible. (Operator Instructions) If you have additional questions, can reach out to Ryan and the Investor Relations team after the call.

那麼，讓我們進入問答環節，我們將嘗試聯繫盡可能多的分析師。 （操作員說明）如果您有其他問題，可以在通話後聯絡 Ryan 和投資者關係團隊。

With that, Brad, can you please give the instructions for asking a question?

那麼，布拉德，您能給予提問的說明嗎？

(Operator Instructions) Lastly, please be advised that this Q&A session is being recorded. For today's session, Geoff, Karen and Ryan are joined by Que Dallara, EVP and President of Diabetes; Mike Marinaro, EVP and President of the Medical Surgical portfolio; Sean Salmon, EVP and President of the Cardiovascular portfolio; and Brett Wall, EVP and President of the Neuroscience portfolio. (Operator Instructions)

（操作員說明）最後，請注意，本次問答環節正在錄製中。出席今天的會議的有 Geoff、Karen 和 Ryan，執行副總裁兼糖尿病業務總裁 Que Dallara 也參加了今天的會議。 Mike Marinaro，執行副總裁兼醫療外科產品組合總裁； Sean Salmon，執行副總裁兼心血管產品組合總裁；執行副總裁兼神經科學業務總裁 Brett Wall。 （操作員說明）

We'll take the first question from Larry Biegelsen at Wells Fargo.

我們將回答富國銀行拉里·比格爾森 (Larry Biegelsen) 提出的第一個問題。

Congratulations on another nice quarter here. I wanted to just focus my one question on the fiscal 2025 comments, Geoff and Karen. You talked about durable growth. Is that -- should we think about that as mid-single-digit organic growth? And just help us -- I think there'll be some concerns about what we're seeing in the Afib business, given the low double-digit decline in the U.S. What are the puts and takes to consider there?

恭喜又一個美好的季度。 Geoff 和 Karen，我想把我的一個問題集中在 2025 財年的評論上。您談到了持久增長。我們是否應該將其視為中等個位數的有機成長？請幫助我們——考慮到美國兩位數的低跌幅，我認為人們會對我們在 Afib 業務中看到的情況感到擔憂。在那裡需要考慮哪些看跌期權和看跌期權？

And on earnings, Karen, can you quantify those headwinds, inflation, tax and FX in fiscal '25? And consensus is at about 5%. Are you comfortable with consensus EPS growth?

關於收益，Karen，您能量化 25 財年的不利因素、通貨膨脹、稅收和外匯嗎？共識約 5%。您對共識每股收益成長感到滿意嗎？

Well, first of all, thanks for the questions, Larry. Maybe I'll start with the CAS one. And then Karen, maybe Sean and I will take the Afib one and then Karen can talk about the FY '25 question.

好吧，首先，謝謝你的提問，拉里。也許我會從 CAS 開始。然後凱倫，也許我和肖恩會參加 Afib 會議，然後凱倫可以談論 25 財年的問題。

So I'm going to phone a friend to have Sean here in a second here. But on our Afib business, look, we are confident in the investments that we made that are going to bear fruit here. We haven't seen it translate into financials yet, but there's lots of leading indicators here that we're seeing that give us confidence both in -- one in continued, I think, stronger performance than people might think in Cryo, but importantly, in PFA for both PulseSelect or organic program and then Affera. But Sean, do you want to comment on this a little more specifically for Larry?

所以我要打電話給一個朋友讓肖恩馬上來。但就我們的 Afib 業務而言，我們對我們所做的投資將在這裡取得成果充滿信心。我們還沒有看到它轉化為財務數據，但我們看到有很多領先指標給了我們信心——我認為，Cryo 的持續表現比人們想像的要強，但重要的是， PulseSelect 或有機程序的PFA，然後是Affera。但是肖恩，你想針對拉里對此發表更具體的評論嗎？

Yes, sure, Geoff. So Larry, in the U.S., what we had experienced was the first time ever a competitor in the Cryo segment. So we had 100% market share, and we had a competitor ramp up their production. We felt that in the fourth quarter. I think there's also some anticipation for new products we're launching, including a Nitron Console, a refresh on our capital equipment for Cryo and, of course, the PulseSelect which just started its launch in the United States after the quarter closed. And that's doing very, very well. The feedback has been exceptional. Doing well in the United States, doing well outside the United States. And I think those catalysts to growth of Pulse Field for both the PulseSelect, that's the single-shot technology as well as our point-by-point ablation is driving a lot of enthusiasm.

是的，當然，傑夫。拉里，在美國，我們所經歷的是冷凍領域有史以來的第一次競爭對手。所以我們擁有 100% 的市場份額，而且我們的競爭對手也提高了產量。我們在第四季就感受到了這一點。我認為人們對我們推出的新產品也有一些期待，包括 Nitron 控制台、Cryo 資本設備的更新，當然還有 PulseSelect，該產品在本季結束後剛在美國推出。這做得非常非常好。反饋非常好。在美國做得很好，在美國以外也做得很好。我認為 PulseSelect 的脈衝場增長的催化劑，即單次技術以及我們的逐點消融正在激發很大的熱情。

So I think we're going to see a return to growth. And into next year, we'll really feel the full force of those launches. So it's a step back, certainly in the United States, with the 11% growth worldwide or outside the United States, I should say, is giving us a lot of confidence. This is a pipeline that's poised to return us to growth in that segment.

所以我認為我們將會看到經濟恢復成長。到明年，我們將真正感受到這些發布的全部力量。所以這是一個退步，當然在美國，全球或美國以外地區 11% 的成長，我應該說，給了我們很大的信心。這條管道將使我們在該領域恢復成長。

Thanks, Sean.

謝謝，肖恩。

And on FY '25, Larry, I would just start with the fact that we're really pleased with our performance through these last several quarters. Q3 was another solid quarter. Our fifth consecutive quarter of solid mid-single digits. And I would point out that we drove that mid-single-digit growth this quarter, off of mid-single-digit comps last year. And that's what we expect to continue into FY '25.

拉里，在 25 財年，我首先要說的是，我們對過去幾季的表現非常滿意。第三季又是穩健的季度。我們連續第五個季度實現穩定的中個位數。我想指出的是，我們在本季實現了中個位數的成長，而去年的成長率為中個位數。這就是我們期望在 25 財年繼續保持的情況。

We've been working through our planning process, and we expect to wrap that up in advance of our Q4 earnings call. So we'll give our guidance in May. Not ready to give you real specifics but from a high level, we've had no major changes to the puts and takes for next year that we discussed on our earnings call in Q2. And we're focused on obviously setting up guidance that sets us up for success, prioritizes innovation and allows us to deliver on our commitments.

我們一直在製定計劃流程，預計在第四季度財報電話會議之前完成。所以我們將在五月給予我們的指導。尚未準備好向您提供真正的細節，但從高層來看，我們在第二季度的財報電話會議上討論的明年的看跌期權和看跌期權沒有重大變化。我們顯然專注於制定指導方針，為我們的成功做好準備，優先考慮創新，並讓我們能夠兌現我們的承諾。

But just on margins and down the P&L. There are puts and takes. We've got inflation that's stabilizing a bit, but it's still higher than historical. Currency is always dynamic. But at recent rates, we are facing a decent headwind from FX, and we'll just have to see how that shakes out.

但只是在利潤率和損益表上。有投入和拿取。我們的通膨有所穩定，但仍高於歷史水準。貨幣總是動態的。但以最近的匯率來看，我們正面臨來自外匯的巨大阻力，我們只需要看看這種情況如何結束。

Global tax reform is likely to be a headwind, but as always, we're focused on driving offsets where we can. And as you know, we've made good and real progress on our COGS cost out work and that started with centralizing our global ops and supply chain and focusing those teams on putting in place tangible programs that we now have in place to drive that cost at work.

全球稅收改革可能會成為逆風，但我們一如既往地致力於盡可能推動抵消。如您所知，我們在 COGS 成本削減工作上取得了良好且實際的進展，首先是集中我們的全球運營和供應鏈，並讓這些團隊集中精力實施我們現在已經制定的切實計劃來降低成本在上班。

And always, we're continuing to focus on driving pricing as an important lever. We've built a new muscle around pricing, and we're just making it stronger and stronger.

我們始終將繼續專注於推動定價作為一個重要槓桿。我們已經在定價方面建立了新的力量，我們正在使其變得越來越強大。

And then we're always focused on controlling expenses. We've got discipline on our largest driver of our expense, which is our headcount, and we expect that to continue. So really, no major changes from what we laid out last quarter.

然後我們始終專注於控制費用。我們對支出的最大驅動因素（即我們的員工人數）有嚴格的紀律，我們預計這種情況將持續下去。事實上，與我們上季度的計劃相比，沒有重大變化。

(Operator Instructions) Brad, can we take the next question, please?

（操作員指示）布拉德，我們可以回答下一個問題嗎？

The next question comes from Robbie Marcus at JPMorgan.

下一個問題來自摩根大通的羅比·馬庫斯。

I wanted to ask on the Patient Monitoring business. The original intent was to try and sell it or spin it. You're now keeping it and exiting the Ventilator business. Just maybe walk us through the thought process, what happened in the market and why this is the best outcome for Medtronic?

我想詢問患者監護業務。最初的目的是嘗試出售或旋轉它。您現在保留它並退出呼吸機業務。也許可以帶我們回顧一下思考過程，市場發生了什麼，以及為什麼這對美敦力來說是最好的結果？

Sure. I'll take that one, Robbie. So a couple of things. I'll start with -- a couple of things have changed. And I'll start with what we have, we do have strong conviction in driving profitable category leadership in this, what we're calling Acute Care and Monitoring business. And a couple of dynamics have changed. And just as a reminder, the Monitoring component -- the Patient Monitoring component is the biggest part of that -- of those businesses that we intended to spin.

當然。我要那個，羅比。有幾件事。首先，有幾件事發生了變化。我將從我們所擁有的開始，我們確實有堅定的信念推動這一領域的盈利類別領導地位，我們稱之為急性護理和監測業務。一些動態已經發生了變化。提醒一下，我們打算進行的業務中，監控​​組件（患者監控組件是其中最大的部分）。

I think the biggest thing that changes our -- 2 things, our improved competitive positioning is -- in our monitoring business, in particular, changed over the last year. As we are working on the process, we continue to run the business, and it performed well. And the competitive dynamics versus our main competitor, Masimo, changed significantly for the positive for us. And we believe that we can ensure that, that change is durable with the increased investment. And we found a way to make that increased investment, which leads to the decision to wind down the vents business.

我認為改變我們的最大的事情——兩件事，我們改善的競爭定位是——在我們的監控業務中，特別是去年發生了變化。當我們致力於流程時，我們繼續經營業務，並且表現良好。與我們的主要競爭對手 Masimo 相比，競爭動態發生了顯著變化，這對我們來說是積極的。我們相信，隨著投資的增加，我們可以確保這種變化是持久的。我們找到了一種增加投資的方法，這導致我們決定結束通風口業務。

It's a very difficult decision, but the business became increasingly unprofitable throughout the last year. The growth slowed even more. And the dynamics within the vent segment are changing, moving to lower acuity ventilators. And our kind of, I'd say, unique and worthy contributions are more in the higher acuity hospital based.

這是一個非常困難的決定，但去年這項業務變得越來越無利可圖。成長速度更加放緩。呼吸器部分的動態正在發生變化，轉向較低敏銳度的呼吸器。我想說，我們的獨特且有價值的貢獻更多是基於更高敏銳度的醫院。

And so with that market changing and becoming increasingly unprofitable, our decision to wind that down creates the oxygen, the investment, if you will, that we can fund the monitoring side of the equation here and ensure that this -- our competitive positioning versus Masimo, we feel like we can extend it.

因此，隨著市場的變化並且變得越來越無利可圖，我們決定逐步減少這一點，從而創造了氧氣，投資，如果你願意的話，我們可以為方程式的監控方面提供資金，並確保我們相對於Masimo 的競爭地位，我們覺得我們可以擴展它。

And another dynamic that has emerged is the use of data and the importance of data in the space, and that's been changing and becoming increasing and actually, I'd say it's the basis for innovation. And our confidence in taking that data and translating that into meaningful iteration, rapid iterations as well as disruption over time is pretty high given what we've been able to do with AI and other parts of the company.

出現的另一個動態是資料的使用以及資料在該領域的重要性，這種情況一直在變化並不斷增加，實際上，我想說這是創新的基礎。考慮到我們在人工智慧和公司其他部門所做的事情，我們對獲取這些數據並將其轉化為有意義的迭代、快速迭代以及隨著時間的推移而產生的破壞的信心非常高。

And so you add all this together, and I probably say the -- last thing I'll make a comment on is, as a company more broadly, we continue to prioritize profitable growth and category leadership. And when you take all these factors together, we believe we're able to provide increased investment for this Acute Care and Monitoring business, or we're calling it ACM now, using the savings from vents and also bringing the 2 -- these were 2 separate businesses, Respiratory Interventions business with ventilators in it and our Monitoring business, bringing them together at the leadership level also creates some savings. And then we can fund the incremental investment needed for the monitoring business, all without dilution to our P&L.

所以你把所有這些加在一起，我可能會說——我要評論的最後一件事是，作為一家更廣泛的公司，我們繼續優先考慮盈利增長和類別領導力。當你把所有這些因素放在一起時，我們相信我們能夠為這個急性護理和監測業務提供更多的投資，或者我們現在稱之為 ACM，利用通風口節省的資金，並帶來 2 - 這些是兩個獨立的業務，即帶有呼吸機的呼吸幹預業務和我們的監測業務，將它們整合到領導層中也可以節省一些成本。然後我們可以為監控業務所需的增量投資提供資金，而不會稀釋我們的損益。

So the last thing I want to say is this is a difficult decision. And it doesn't take anything away from our employees who play such a pivotal role during COVID in driving ventilator innovation and responding to the global needs during the COVID pandemic. And I also want to give a nod to the -- just the legacy of Puritan Bennett brand, which has been so strong. And we're proud of the rich legacy of this business and Puritan Bennett Ventilators and this decision has not been easy.

所以我想說的最後一件事是，這是一個艱難的決定。這並沒有剝奪我們員工的任何東西，他們在新冠肺炎疫情期間在推動呼吸機創新和應對全球需求方面發揮關鍵作用。我還想向 Puritan Bennett 品牌的遺產致敬，它是如此強大。我們為這項業務和 Puritan Bennett 呼吸器的豐富遺產感到自豪，但這個決定並不容易。

And the last thing I'll say is, this does not mean that we're going to shy away from additional portfolio moves. So don't read anything into that. But the bar is high for any strategic activity that's going to dilute our focus or our earnings.

我要說的最後一件事是，這並不意味著我們將迴避額外的投資組合變動。所以不要讀任何內容。但對於任何會削弱我們的關注點或收益的策略活動來說，門檻都很高。

We'll take the next question. Please, Brad.

我們將回答下一個問題。拜託，布拉德。

The next question comes from Joanne Wuensch at Citi.

下一個問題來自花旗銀行的 Joanne Wuensch。

There are a lot of products that I could ask about. So I'm just going to throw a couple of headline ones out there. Diabetes, congratulations on a return to U.S. growth. Is there a way to peel that apart a little bit on the new accounts or new patients versus renewals?

有很多產品我可以詢問。所以我只想拋出幾個標題。糖尿病，祝賀美國經濟恢復成長。有沒有辦法在新帳戶或新病患與續約方面稍微區分一下？

And I guess my second question has to do with Hugo and if you can give us a little bit of a state of an update on how those launches are going outside the United States?

我想我的第二個問題與雨果有關，您能否向我們介紹一下這些產品在美國境外的發射情況的最新情況？

Thanks, Joanne, for the questions. Obviously, we're -- we've been working on this Diabetes turnaround for some time, and it hasn't been a straight line. But we definitely have some momentum here on 780G, that platform, and just our capabilities here to use the data like I was talking about the Patient Monitoring business here as well, to create algorithms that really are differentiated and drive differentiated outcomes for patients. And that's playing out globally and now in the United States. So I'll have Que -- maybe Que, if you could come in and answer Joanne's -- if you could "Peel it apart" a little bit more for Joanne. I'll appreciate it.

謝謝喬安妮的提問。顯然，我們已經為扭轉糖尿病局面而努力了一段時間，但這並不是一條直線。但我們在 780G 這個平台上肯定有一些動力，而且我們有能力使用數據，就像我在這裡談論的患者監護業務一樣，創建真正差異化的演算法並為患者帶來差異化的結果。這種情況正在全球上演，現在又在美國上演。所以我會邀請 Que——也許是 Que，如果你能進來回答喬安妮的問題的話——如果你能為喬安妮多“剝開它”一點。我會很感激的。

Yes. Look, we're very pleased with the progress that we've made every quarter since 780G had launched. And we are seeing new patients grow significantly as well as renewals. So both are progressing very well.

是的。看，我們對自 780G 推出以來每個季度的進展感到非常滿意。我們看到新患者和續訂患者都顯著成長。所以兩者都進展得很好。

Look, it will take time to rebuild our installed base, but you can see with the pump growth that we saw in the U.S., high 40s year-over-year. That's going to be followed by consumables and CGM growth as well. So we expect to continue to make progress every quarter, but pretty pleased with how the markets reacted to the product introduction.

看起來，重建我們的安裝基礎需要時間，但你可以看到我們在美國看到的泵浦的增長，比去年同期增長了 40 倍以上。隨之而來的是消耗品和 CGM 的成長。因此，我們預計每季都會繼續取得進展，但對市場對產品推出的反應感到非常滿意。

Okay. Thanks, Que. Mike Marinaro, can you jump in on Hugo here?

好的。謝謝，闕。麥克‧馬裡納羅（Mike Marinaro），妳能插話一下雨果嗎？

Yes. Thanks, Joanne, for the question. We continue to see very good progress with Hugo outside the United States with an expansion of installations in countries around the globe. In fact, we entered into 2 new subregions in Central and Eastern Europe and are continuing to see very good response to the things we've talked about previously.

是的。謝謝喬安妮提出的問題。我們繼續看到 Hugo 在美國以外的地區取得了非常好的進展，並在全球各國擴大了安裝範圍。事實上，我們進入了中歐和東歐的兩個新次區域，並且繼續看到我們之前討論過的事情得到了很好的反響。

So the open console, the very crisp visualization and increasingly very good feedback around our Touch Surgery Enterprise platform, which on its own continues to expand and had a very good quarter with installations, both with Hugo and in our broader surgical business.

因此，開放式控制台、非常清晰的可視化以及圍繞我們的TouchSurgery Enterprise 平台越來越好的反饋，該平臺本身不斷擴展，並且在Hugo 和我們更廣泛的外科業務中都有一個非常好的安裝季度。

Also, as Geoff noted during the commentary, we continued very good progress with our expand Euro IDE here in the U.S. and are preparing for our first patient enrollment in hernia IDE. So in total, a good reception, a sharpening sort of appreciation for the features of Hugo, I think an emergence of the digital ecosystem and an appreciation for that as well.

此外，正如 Geoff 在評論中指出的那樣，我們在美國擴展歐洲 IDE 方面繼續取得了良好進展，並且正在為疝氣 IDE 的第一例患者入組做準備。總的來說，這是一種良好的接待，對雨果功能的一種尖銳的欣賞，我認為數位生態系統的出現以及對此的欣賞。

Yes, I'd say, Joanne, on this one -- thanks, Mike, first of all. And I'd say on this one, the robotic system and the features are differentiated and had been well received, but it's broader than that, as Mike pointed out. I mean, it's about the digital platform that comes with it and -- as well as the instrumentation as we transition instrumentation in our laparoscopic business onto the robot, particularly stapling and energy. All these moves build momentum -- build capabilities and momentum over time.

是的，我想說，喬安妮，關於這個——首先謝謝麥克。我想說的是，在這一點上，機器人系統和功能是與眾不同的，並且受到了好評，但正如邁克指出的那樣，它的範圍比這更廣泛。我的意思是，這與它附帶的數位平台以及儀器有關，因為我們將腹腔鏡業務中的儀器轉移到機器人上，特別是縫合和能源。所有這些舉措都會增強動力——隨著時間的推移增強能力和動力。

We're seeing -- we saw that play out in the Spine business. We bought Mazor, and it wasn't an overnight change. You saw where our last couple of quarters have been, but it took the integration of these things. Mazor with our navigation and then imaging and then getting these AI-guided surgical planning systems, all these things coming together, every quarter, more progress have built the ecosystem we have today that's really driving not just the growth for Medtronic but the growth for the spine industry right now. And we expect to do the same thing in soft tissue surgery.

我們看到——我們看到這種情況在脊椎業務中發揮作用。我們買了 Mazor，這並不是一夜之間的改變。你看到了我們過去幾個季度的表現，但它需要整合這些東西。 Mazor 透過我們的導航、成像，然後獲得這些由人工智慧引導的手術計劃系統，所有這些東西結合在一起，每個季度，更多的進步構建了我們今天擁有的生態系統，這不僅真正推動了美敦力的成長，而且推動了整個醫療產業的成長。現在的脊椎產業。我們希望在軟組織手術中做同樣的事情。

We'll take the next question, please, Brad.

我們將回答下一個問題，布拉德。

The next question comes from Travis Steed at Bank of America.

下一個問題來自美國銀行的 Travis Steed。

Geoff, curious if you could talk a little bit more on the gross margin productivity. Some of the things you're driving there. And can you still get the kind of 2 to 3x annual cost savings on the gross margin line?

傑夫，很好奇您能否多談談毛利率生產力。你開車去那裡的一些東西。您還能在毛利率線上達到 2 到 3 倍的年度成本節省嗎？

And last month, at the investor conference, you talked a lot about leveraged EPS growth. I'm just curious if that's a comment that applies to FY '25 or if that was more of a longer-term comment?

上個月，在投資人會議上，您談到了許多關於槓桿每股收益成長的問題。我只是好奇這是否適用於 25 財年的評論，或者這是否是更長期的評論？

Sure. Let me -- I'll start it off and transition to Karen. On the gross margin, a couple of things that I'd point out. One is pricing, Karen talked about that. I do think -- what we're seeing here is a lot of innovation in the industry and a lot at Medtronic. And this innovation we're finding is valued. It drives value in the health system. And I think we've gotten better at showing the health economics of the innovation that applies from the innovation in addition to the clinical value. I think in the past, we were pretty indexed on clinical value. And more recently, we keep that focus and then add the health economics, and it's getting paid for. And we're, I think, doing a better job of making those points and getting that pricing. And I do think it's durable. So the pricing has increased, I'd say, for the company overall 200 basis points or so relative to the past. And I think we're going to keep pushing for even more.

當然。讓我——我將開始並過渡到凱倫。關於毛利率，我想指出一些事情。其中之一是定價，凱倫談到了這一點。我確實認為——我們在這裡看到的是產業內的大量創新，美敦力也有很多創新。我們發現的這項創新很有價值。它推動了衛生系統的價值。我認為，除了臨床價值之外，我們也更好地展示了創新的健康經濟學。我認為過去我們非常注重臨床價值。最近，我們繼續關注這一重點，然後添加健康經濟學，它得到了回報。我認為，我們在闡述這些觀點並獲得定價方面做得更好。而且我確實認為它很耐用。因此，我想說，相對於過去，公司整體定價上漲了 200 個基點左右。我認為我們將繼續努力爭取更多。

On the converse, if you don't have the innovation, be prepared for that as well because I think hospitals have gotten more sophisticated in the purchasing and your price is going to pay for that if you're not keeping up with the innovation. But we -- given where we are on the product cycles and given this pricing loss, so we feel good about that being incremental especially to the historical baseline.

相反，如果你沒有創新，也要為此做好準備，因為我認為醫院在採購方面已經變得更加複雜，如果你跟不上創新，你的價格就會付出代價。但考慮到我們在產品週期中的位置以及定價損失，因此我們對增量尤其是相對於歷史基準的增量感到滿意。

The other you asked about is cost of goods sold productivity. And the answer -- the short answer to your question is yes, we do think it's sustainable. We've got lots of opportunity here. Can you think about it, we have this pretty big footprint of factories and distribution centers and too many suppliers, as I said in the past.

您問的另一個問題是銷售成本生產力。答案 - 對你的問題的簡短答案是肯定的，我們確實認為這是可持續的。我們這裡有很多機會。你能想一下嗎，正如我過去所說，我們有相當大的工廠和配送中心以及太多的供應商。

Now with Greg Smith coming in a couple of years ago and we've centralized that, we can take a strategic look across that portfolio and we have a long list of cost down programs. And then we've ensured that we've effectively contracted those between our global operations and supply chain team and our operating units. Because it takes release product engineering to make sure that these cost programs can happen that are in our operating units. So we feel good about that, and we feel that that's sustainable.

現在，隨著格雷格史密斯幾年前的加入，我們已經集中了這一點，我們可以對整個投資組合進行策略性審視，並且我們有一長串的成本降低計劃。然後，我們確保我們的全球營運和供應鏈團隊與我們的營運部門之間有效地簽訂了合約。因為需要發布產品工程來確保這些成本計劃能夠在我們的營運單位中實施。所以我們對此感覺良好，並且我們認為這是可持續的。

So those are 2 big changes that impact positively gross margins now and into the future. And speaking of the future, I'll turn it over to Karen to talk about your FY '25 leverage question.

因此，這是對現在和未來的毛利率產生正面影響的兩大變化。說到未來，我將把它交給凱倫來談談您的 25 財年槓桿問題。

Yes. So just on -- I'll just add on gross margins, too. We're pleased with our performance that we had this quarter. We overcame a 60 basis point headwind from FX and continued inflationary pressures. And a lot of that was driven by strong pricing, which Geoff talked about. We also did have some continued delays in China VBPs, in Aortic and Peripheral Vascular and Stapling. And those VBPs could be coming through this coming fourth quarter -- this current fourth quarter and potentially into next year. So that's just something going on in gross margins.

是的。那麼，我也會增加毛利率。我們對本季的表現感到滿意。我們克服了來自外匯和持續通膨壓力的 60 個基點阻力。傑夫談到，這很大程度上是由強勁的定價推動的。我們在中國的 VBP、主動脈和周邊血管及吻合術方面也確實出現了一些持續的延遲。這些 VBP 可能會在即將到來的第四季度實現——當前的第四季度，並可能持續到明年。這就是毛利率的變動。

As we talk -- as we think about leverage down the P&L, clearly, we're focused on driving leverage. And I think we talked about it last quarter, Travis, clear leverage is where your bottom line grows faster than your top line. We're focused on getting there eventually. We're not ready to talk about that for FY '25. It's still too early for our planning guidance. And I've already pointed out lots of different puts and takes for next year.

當我們談論降低損益表的槓桿時，顯然，我們專注於提高槓桿率。我想我們上個季度討論過，特拉維斯，明確的槓桿是你的利潤成長速度快於營收成長的地方。我們專注於最終實現這一目標。我們還沒準備好在 25 財年談論這個問題。對於我們的規劃指導來說還為時過早。我已經指出了明年的許多不同的安排和要求。

Yes. Karen said pricing on the gross margin side, pricing, cost of goods sold productivity, a lot of focus there. Karen mentioned earlier on the call about discipline around our G&A. Our people are the #1 driver of our cost there. And so we've put a discipline in there that we're holding to. And then finally, just setting up the portfolio for profitable growth.

是的。凱倫表示，定價方面，毛利率、定價、銷售成本、生產力等都是許多關注的焦點。凱倫早些時候在電話會議上提到了我們的一般及行政費用紀律。我們的員工是我們成本的第一驅動因素。因此，我們制定了我們所堅持的紀律。最後，只是建立投資組合以實現獲利成長。

And the decision on -- with the changing dynamics, the decision to hold our monitoring business because of the confidence in the profitable growth is evidence of that, is setting up the portfolio the right way. So I'll leave it there on the focus of -- on recovering the earnings power of the company and we'll provide more details on that FY '25 look next quarter.

隨著動態的變化，由於對獲利成長的信心而決定保留我們的監控業務就是證據，正在以正確的方式建立投資組合。因此，我將把重點放在恢復公司的獲利能力上，我們將在下個季度提供有關 25 財年展望的更多細節。

Next question, Brad?

下一個問題，布拉德？

The next question comes from Vijay Kumar at Evercore ISI.

下一個問題來自 Evercore ISI 的 Vijay Kumar。

I guess one on earnings questions here. I look at your peers, their earnings have grown versus fiscal '19 -- 2019 pre-pandemic levels. Medtronic earnings have essentially been flattish. Can Medtronic commit to perhaps about trend earnings growth over the medium term as you play catch up similar to what your peers have done?

我想這裡有一個關於收入的問題。我看看你們的同行，他們的收入與 19 財年至 2019 年大流行前的水平相比有所增長。美敦力（Medtronic）的獲利基本持平。當您追趕與同業類似的做法時，美敦力能否承諾在中期內實現獲利趨勢成長？

And I think related to that, Geoff, in the past, you mentioned about a $400 million drag from investments in Ardian, Hugo. Where are we on those investments? Are they still a drag? When can those be profitable to the business?

我認為與此相關的是，Geoff，您過去提到對 Ardian、Hugo 的投資造成了 4 億美元的拖累。我們這些投資進展到什麼程度了？他們仍然是一個拖累嗎？這些何時能為企業帶來獲利？

Thanks, Vijay, for the questions. I'll start with the latter question on Ardian and Hugo and let Karen handle the earnings growth ones and further comment on the Ardian and Hugo. I'd say on -- look, Hugo -- the way we're looking at Hugo is a part of our broader surgical franchise, an important part of that and it needs investment. And it is -- if you look at Hugo specifically, it is taking a meaningful amount of investment to keep it going here. We've reached -- I love the milestone that we're at now in terms of a robot that's out there that's performing well and has got great features that are valued by physicians globally. The feedback has been strong, but we still got more work to do.

謝謝維傑提出的問題。我將從關於 Ardian 和 Hugo 的後一個問題開始，讓 Karen 處理收益成長問題，並進一步評論 Ardian 和 Hugo。我想說的是——看，雨果——我們看待雨果的方式是我們更廣泛的外科特許經營權的一部分，是其中的重要組成部分，它需要投資。確實如此——如果你具體看看 Hugo，你會發現它需要大量的投資來維持它的發展。我們已經達到了——我喜歡我們現在所達到的里程碑，因為我們的機器人性能良好，並且具有受到全球醫生重視的出色功能。回饋很強烈，但我們還有更多工作要做。

We've got to get our instruments on there. We've got to complete the U.S. trial. We've got to continue to build out a U.S. -- a capital equipment U.S. sales force. So this is a tall order. But our confidence in executing there is high, and it's important to this huge business, our surgical business, which is our biggest business and drives a lot of profit and cash flow.

我們必須把我們的儀器放在那裡。我們必須完成美國的審判。我們必須繼續在美國建立一支資本設備美國銷售團隊。所以這是一個艱鉅的任務。但我們對在那裡執行的信心很高，這對我們的外科業務這個龐大的業務很重要，這是我們最大的業務，可以帶來大量的利潤和現金流。

And I say our confidence is high. I know we're up against a strong competitor in Intuitive. But we like our competitive positioning overall and especially against the other potential robotic companies there and dynamics of this market, we think, play in our favor. So there's investment there.

我說我們信心十足。我知道我們在 Intuitive 領域面臨著一個強大的競爭對手。但我們喜歡我們的整體競爭地位，特別是與其他潛在的機器人公司相比，我們認為這個市場的動態對我們有利。所以那裡有投資。

On Ardian, and by the way, we're really trying to call it Simplicity now. We've got to get -- we'll get ready for some consumer education on this hypertension therapy. So we're trying to get rid of the Ardian term as much as possible. So we've got a square [jargon] on around here on that one. But on hypertension, this one, we believe, will start to show some profits here. So it's much less of a drag, and we hope to, in the next couple of quarters and in the medium term, this to generate not just revenue but income. It's a highly profitable product line for us with high gross margins, and it will be a positive to our overall mix.

順便說一句，在 Ardian 上，我們現在確實想將其稱為“簡單”。我們必須做好準備，對這種高血壓療法進行一些消費者教育。因此，我們正在嘗試盡可能地擺脫 Ardian 術語。所以我們在這附近有一個方形的[行話]。但在高血壓方面，我們相信，這一點將開始顯示出一些利潤。因此，它的阻力要小得多，我們希望在接下來的幾季和中期內，這不僅能產生收入，還能產生收入。這對我們來說是一條高利潤的產品線，毛利率很高，這將對我們的整體組合產生正面的影響。

And like I said, Hugo is going to take investment, but this one, I think, will provide oxygen, not in the next quarter or 2, but over the medium term here. So I'll leave it there, but it's -- and turn it over to Karen.

就像我說的，雨果將接受投資，但我認為，這項投資將提供氧氣，不是在下一兩個季度，而是在中期。所以我會把它留在那裡，但它是——然後把它交給凱倫。

Yes. And I would just say on earnings, we've made good progress on driving the earnings power of the company just in this year. I noted that we've been able to increase our guidance on the bottom line by $0.15 at the midpoint from where we initially started the year, and that's driven by the strong track record that we've drove -- that we've driven in the last -- the first 3 quarters of this year. And we do expect that to continue.

是的。我只想說，就獲利而言，我們今年在推動公司獲利能力方面取得了良好進展。我指出，我們已經能夠將我們的淨利潤指引從年初的中點提高了 0.15 美元，這是由我們所取得的強勁業績記錄推動的——我們在最後——今年前三個季度。我們確實希望這種情況能夠持續下去。

Over the medium and long term, we are committed to the right earnings growth. There's no debate about that. And we're focused on overcoming the headwinds that we've got over that time frame and delivering on that growth.

從中長期來看，我們致力於實現適當的獲利成長。對此沒有爭議。我們專注於克服在這段時間內遇到的阻力並實現成長。

We probably have time for 2 more questions, Brad, take 2 more.

我們可能還有時間再問 2 個問題，布拉德，再問 2 個問題。

The next question goes to Matt Miksic at Barclays.

下一個問題將問巴克萊銀行的馬特·米克西奇。

Great. So maybe just a follow-up here on some of the products that you've mentioned recently approved and I think some of the products that you hope to see approved in the coming quarters, and I'm thinking of like AURORA and PulseSelect and maybe additions to the U.S. approved products in Diabetes. And I know Sean mentioned sort of the rough trajectory for AF ablation. But maybe on that business, for example, any additional color around cadence? Is this something that we start to see improve in the fourth quarter? Or is this sort of like an early to mid-'25 kind of process on some of the same commentary for sort of cadence and trajectory in AURORA and for example, maybe the Diabetes business would be super helpful.

偉大的。因此，也許只是您提到的最近批准的一些產品的後續行動，我認為您希望在未來幾個季度看到批准的一些產品，我正在考慮像 AURORA 和 PulseSelect ，也許美國批准的糖尿病產品的補充。我知道 Sean 提到 AF 消融的大致軌跡。但也許在這方面，例如，圍繞節奏有任何額外的色彩嗎？我們在第四季開始看到這一點有所改善嗎？或者這有點像 25 年初到中期的過程，對 AURORA 中的節奏和軌跡進行一些相同的評論，例如，也許糖尿病業務會非常有幫助。

Sure. So maybe I'll start with Sean. Before I turn it over to Sean, as I pointed out in the commentary, all the puts and takes in the -- our ablation business, what we call Cardiac Ablation Solutions, our Afib business, we do see an acceleration in this business even in the fourth quarter here. So -- but I'll turn it over to Sean to talk about Afib and then AURORA.

當然。所以也許我會從肖恩開始。在我把它交給肖恩之前，正如我在評論中指出的，我們的消融業務，我們所說的心臟消融解決方案，我們的心房顫動業務中的所有投入和投入，我們確實看到了這項業務的加速，即使在第四季在這裡。所以——但我會把它交給 Sean 來談談 Afib，然後是 AURORA。

Yes. Thanks, Geoff. And Matt, the trajectory is obviously going to be upward for both the EV-ICD as well as the CAS business in total. As you launch these new technologies, there's some training that you have to do to make sure that the physicians are comfortable with how to use the products. And that's, of course, something we're very deliberate about to make sure that there's a good patient outcome and good acceptance of the technology. And that's something we do pretty frequently in our business. So we're really, really good at it. And the feedback has been excellent.

是的。謝謝，傑夫。 Matt 表示，EV-ICD 和 CAS 業務的整體發展軌跡顯然都是向上的。當您推出這些新技術時，您必須進行一些培訓，以確保醫生熟悉如何使用這些產品。當然，這是我們非常謹慎的事情，以確保患者獲得良好的治療效果並獲得對技術的良好接受。這是我們在業務中經常做的事情。所以我們真的非常擅長。反饋非常好。

The procedure efficiency on PulseSelect has been -- we're getting these cases done in like half an hour. And the acceptance on AURORA has been exceptional, too. So as I said, I think it's the same story for both those technologies where you push growth now, but into next year, we'll see the full impact of these innovations.

PulseSelect 的程式效率是——我們在大約半小時內完成了這些案例。 AURORA 的接受度也非常高。正如我所說，我認為對於現在推動成長的這兩種技術來說，情況都是一樣的，但到明年，我們將看到這些創新的全面影響。

Que, you want to comment on Diabetes?

闕，你想對糖尿病發表評論嗎？

Yes. Look, we continue to push the pipeline in diabetes, starting with Simplera approved with CE Mark last September, followed by Simplera Sync recently approved that we announced at JPMorgan and we completed our clinical trials for 780G with Simplera Sync in the U.S., which we expect us to [meet] in this first half of the calendar year. So that's the cadence that you should expect.

是的。看，我們繼續推動糖尿病領域的研發，首先是去年9 月獲得CE 標誌批准的Simplera，隨後是我們在摩根大通宣布的Simplera Sync 最近獲得批准，並且我們通過Simplera Sync 在美國完成了780G 的臨床試驗，我們預計這一結果我們將在今年上半年[見面]。這就是您應該期待的節奏。

And as Geoff mentioned in his opening comments, we have next-generation products that we discussed at ADA last year that we continue to make progress on and aggressively moving to get next-generation tethered pumps and patch pumps out to the market.

正如 Geoff 在開場白中提到的那樣，我們擁有去年在 ADA 上討論過的下一代產品，我們將繼續取得進展，並積極推動將下一代系留泵和貼片泵推向市場。

I apologize to the analysts that we weren't able to get to you. We have time though for one more, Brad.

對於未能聯繫到您，我向分析師表示歉意。不過，我們還有時間再談一談，布拉德。

The final question comes from Anthony Petrone at Mizuho Securities.

最後一個問題來自瑞穗證券的安東尼佩特龍。

Okay. Great. One, condolences on passing of Tom to the team and his family. And maybe one just going to Structural Heart. Maybe just to set up on the SMART study, quick two-part question. One, was that ahead of schedule? Was it expected to be at TCT instead of ACC? So is the late breaker getting approved a surprise? And then maybe just high level, how do you think that study will play out once we have the results? It is head-to-head in TAVR, in high-risk symptomatic severe. So just thoughts on how you think that data is received once it's out there post ACC at that session in the coming weeks?

好的。偉大的。第一，對湯姆去世向團隊及其家人表示哀悼。也許有人只是去結構心臟。也許只是為了建立 SMART 研究，快速提出兩部分問題。一，這是否提前了？預計會在 TCT 而不是 ACC 進行嗎？那麼，遲到的突破者獲得批准是一個意外嗎？然後也許只是高水平，一旦我們得到結果，你認為這項研究將如何進行？在 TAVR 中，在高危險症狀嚴重的患者中，這是針鋒相對的。那麼，您認為在未來幾週的 ACC 會議上資料發布後，您將如何接收資料？

Well, thanks -- first of all, Anthony, thanks for the comment Tom Holloran. He's a real legend around here and just a great guy. So we're going to miss him.

好吧，謝謝——首先，安東尼，感謝湯姆·霍洛蘭的評論。他是這裡真正的傳奇人物，也是一個偉大的人。所以我們會想念他的。

On Structural Heart, 2 comments before I turn it over to Sean. First, I really applaud the business for their evidence generation in total. On -- we just did our low-risk data and we publish it every year, not just when it's convenient. And then they had the courage to do a head-to-head, which is not something that's often done in our space.

在《結構心臟》上，在我把它交給 Sean 之前有 2 條評論。首先，我真的很欣賞該公司在整個證據生成過程中的表現。我們只是做了低風險數據，並且每年都會發布它，而不僅僅是在方便的時候發布。然後他們有勇氣進行正面交鋒，這在我們的領域並不常見。

And so I can tell you that I, for one, love that, just the commitment to data and the competitiveness to go head-to-head. And I'm very much looking forward to the results that are going to come out in early April at ACC. But in terms of the specifics of what you're asking on how it might play out, I'll turn that over to Sean.

所以我可以告訴你，我個人很喜歡這一點，就是對數據的承諾和正面交鋒的競爭力。我非常期待四月初 ACC 公佈的結果。但就你所詢問的具體情況而言，我會將其轉交給肖恩。

Yes. Thanks, Anthony. The completement of enrollment happened in October of '22. So that's a 12-month endpoint for the study, and that pushes you really out of the window for TCT. So I think we're on schedule, I'd say. Pleased to have been accepted as a late breaker at ACC. But that's really, as expected, I'd say.

是的。謝謝，安東尼。註冊工作於 2022 年 10 月完成。因此，這是該研究的 12 個月終點，這將您真正排除在 TCT 之外。所以我想說，我認為我們正在按計劃進行。很高興被接受為 ACC 的遲到突破者。但我想說，這確實是預料之中的。

In terms of the trial itself and how it'll be received, I think just right, the momentum that we have on data from the notion 10-year data that's low-risk patients out to 10 years showing superior durability of our valve compared to surgical implants and then our 4-year low-risk study with hard endpoint benefits and a widening benefit on serious outcomes like mortality and disabling stroke. And, of course, going head-to-head in a really important patient population, those with a small (inaudible) we said that's about 40% of the global market, really prevalent among women and within smaller patient populations like in Japan, for example.

就試驗本身以及如何接受試驗而言，我認為恰到好處，我們從 10 年數據的概念中獲得的動力，即低風險患者在 10 年內顯示出我們的瓣膜與其他瓣膜相比具有卓越的耐用性手術植入，然後是我們為期4 年的低風險研究，該研究具有硬終點效益以及對死亡率和致殘性中風等嚴重後果的廣泛效益。當然，在非常重要的患者群體中進行正面交鋒，我們說這些患者群體規模較小（聽不清楚），約佔全球市場的 40%，在女性和日本等較小的患者群體中非常普遍，因為例子。

So that's -- I think it's really important and compelling data. It's a 1-year outcome, which portends long-term outcomes. And I think that we're excited for the reception of these results. And we do think that, that's a catalyst for growth for us with our really unique position in that particular subset of patients, which is a big chunk of the market at 40%.

所以我認為這是非常重要且令人信服的數據。這是一年的結果，預示著長期的結果。我認為我們對收到這些結果感到興奮。我們確實認為，這對我們來說是成長的催化劑，因為我們在特定患者群體中擁有真正獨特的地位，該群體佔市場的很大一部分，佔 40%。

Okay. Thanks, Sean. And so just to wrap it up here. One final comment on the ventilation -- the monitoring and ventilation decisions. As a result of these portfolio decisions, Bob White will be leaving Medtronic, and he's been just such an impactful and important leader for the company for a long time. And although the friendship will remain strong, we're definitely going to miss working with him day to day, and I want to wish him well. And I know that comes from the Board of Directors and the executive committee and everybody at Medtronic who's interacted with Bob. Just a high ethical leader and just a good guy and we wish him well.

好的。謝謝，肖恩。就到這裡結束吧。關於通風的最後一個評論是監測和通風決策。由於這些投資組合決策，鮑伯懷特（Bob White）將離開美敦力（Medtronic），而他長期以來一直是該公司極具影響力和重要的領導者。儘管友誼依然牢固，但我們肯定會懷念與他一起工作的每一天，我祝他一切順利。我知道這來自董事會、執行委員會以及美敦力與鮑伯互動過的每個人。他是個道德高尚的領導者，一個好人，我們祝他一切順利。

And in terms of -- and so for (inaudible) today, I just want to thank everybody for the questions. Definitely appreciate your support and continued interest in Medtronic, and we hope you'll join us again for our Q4 earnings broadcast, which we anticipate holding on Thursday, May 23. And again, we'll update you on our progress and how we finish the fiscal year, but also look ahead to fiscal '25. So with that, thanks for spending time with us today, and have a great rest of your day.

就今天（聽不清楚）而言，我只想感謝大家提出的問題。非常感謝您對美敦力的支持和持續關注，我們希望您能再次加入我們的第四季度收益廣播，我們預計將於 5 月 23 日星期四舉行。我們將再次向您通報我們的進展和完成情況展望本財年，同時也展望25 財年。因此，感謝您今天與我們共度時光，並祝您有個愉快的一天。