美敦力 (MDT) 2022 Q4 法說會逐字稿

Good morning. I'm Ryan Weispfenning, Vice President and Head of Medtronic Investor Relations, and I appreciate that you're joining us today for Medtronic's Fiscal Year 2022 Fourth Quarter Earnings Video Webcast.

早安.我是美敦力公司副總裁兼投資人關係主管 Ryan Weispfenning。感謝您今天參加美敦力 2022 財年第四季財報視訊網路直播。

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.

在我們進入會議室聆聽準備好的發言之前，我想先分享一些關於今天網路直播的細節。與我一起發言的還有美敦力董事長兼執行長傑夫‧瑪莎 (Geoff Martha) 和美敦力財務長凱倫‧帕克希爾 (Karen Parkhill)。

Geoff and Karen will provide comments on the results of our fourth quarter and fiscal year 2022, which ended on April 29, 2022, and our outlook for fiscal year '23. After our prepared remarks, our portfolio executive VPs 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.

Geoff 和 Karen 將就我們截至 2022 年 4 月 29 日的 2022 財年第四季及全年業績以及 2023 財年的展望發表演說。在我們準備好的發言之後，我們的投資組合執行副總裁將加入討論，我們將回答負責公司業務的賣方分析師的問題。今天的節目大約持續一小時。

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.

今天早上早些時候，我們發布了一份新聞稿，其中包含我們的財務報表以及各部門和地區收入摘要。我們也發布了一份收益報告，詳細介紹了我們的業績。您可以在我們的收益新聞稿中或造訪我們的網站 investorrelations.medtronic.com 取得該報告。

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 statement. 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的預測有重大差異。有關可能導致實際結果出現差異的因素的更多信息，請參閱我們向美國證券交易委員會 (SEC) 提交的定期報告和其他文件。我們不承擔更新任何前瞻性陳述的義務。

Unless we say otherwise, all comparisons are on a year-over-year basis, and revenue comparisons are made on an organic basis, which this quarter includes only adjustments for foreign currency as there were no acquisitions or divestitures 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，所有比較均按同比計算，收入比較按有機基礎進行，本季度僅包括外幣調整，因為過去 4 個季度沒有發生對公司整體或個別部門季度收入增長產生重大影響的收購或資產剝離。

References to sequential revenue changes compared to the third quarter of fiscal '22 and are made on an as-reported basis and all references to share gains or losses refer to revenue share in the first calendar quarter of 2022 compared to the first calendar quarter of 2021, unless otherwise stated.

與 22 財年第三季相比，所提及的連續收入變化均以報告為基礎，所有提及的份額收益或損失均指 2022 年第一季與 2021 年第一季相比的收入份額，除非另有說明。

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.

所有非公認會計準則 (Non-GAAP) 財務指標的對帳表可在我們的收益新聞稿或我們的網站 investorrelations.medtronic.com 上查閱。最後，我們的每股盈餘預期不包含任何將在本會計年度以非公認會計準則 (Non-GAAP) 調整收益的費用或收益。

With that, let's head into the studio and get started.

有了它，讓我們走進工作室開始。

(presentation)

（推介會）

Hello, everyone, and thank you for joining us today. This morning, we reported our Q4 results. Now there were parts of the quarter that played out as anticipated, and there were also some unexpected challenges, more than I would have liked, which caused us to come up short of our expectations.

大家好，感謝大家今天加入我們。今天上午，我們公佈了第四季的業績。本季的部分業績符合預期，但也遇到了一些意料之外的挑戰，這些挑戰比我預想的要多，導致我們未能達到預期。

As we anticipated, procedure volumes in most of our markets reached pre-COVID levels by the end of the quarter. We also executed and delivered on recent product launches. However, we faced challenges related to supply chain in China that impacted some of our businesses and were the largest contributors to our shortfall.

正如我們預期，到本季末，我們大多數市場的手術量已恢復到疫情前的水平。我們也成功執行並交付了近期發布的產品。然而，我們在中國面臨與供應鏈相關的挑戰，這影響了我們的部分業務，也是造成我們業務缺口的最大原因。

Now I'll get into more detail on these challenges shortly, but you should take away that we understand the root causes and we are well down the path to addressing them. And to be prudent, however, we've assumed that these challenges will persist for the next quarter or 2 in the guidance that Karen is going to walk you through shortly. So let's focus on what happened this quarter.

現在我很快就會更詳細地闡述這些挑戰，但各位應該明白，我們了解根本原因，並且正在努力解決這些問題。不過，為了謹慎起見，我們在凱倫即將發布的指導方針中假設這些挑戰將持續到下一季或下兩個季度。所以，讓我們先來關註一下本季的情況。

The shortfall to our revenue guidance was primarily due to 2 factors: China, where the extended COVID lockdowns affected our results in the quarter particularly in April, and global supply chain challenges.

我們的收入未達到預期主要是由於兩個因素：中國，延長的新冠疫情封鎖影響了我們本季的業績，特別是 4 月份的業績，以及全球供應鏈挑戰。

Over the past few quarters, global supply chain challenges have impacted many of our businesses. And as they arise, our teams have worked quickly to resolve them, and prior to this quarter, we have largely mitigated their financial impact.

過去幾個季度，全球供應鏈挑戰影響了我們的許多業務。這些挑戰一出現，我們的團隊就迅速採取行動予以解決，在本季之前，我們已在很大程度上減輕了這些挑戰帶來的財務影響。

However, this quarter, one of our largest businesses, Surgical Innovations, was adversely affected by certain raw material shortages, and this resulted in large back orders and caused our SI revenue to come in well below our expectations. Several of our other businesses also face supply challenges in the quarter, but to a lesser extent.

然而，本季度，我們最大的業務之一——外科創新業務（Surgical Innovations）受到了某些原材料短缺的不利影響，導致大量訂單積壓，並導致我們的外科創新業務（SI）收入遠低於預期。我們的其他幾項業務在本季也面臨供應挑戰，但程度較輕。

Now we're down the path of improving our supply chain capabilities, and we're leveraging the expertise that Greg Smith, our new Global Ops and Supply Chain leader brings from the retail, consumer products and automotive industries. Greg and his team are making progress addressing the areas where we can improve, including the management and resiliency of our critical suppliers and manufacturing network.

目前，我們正在提升供應鏈能力，並充分利用新任全球營運和供應鏈主管格雷格·史密斯在零售、消費品和汽車行業的專業知識。格雷格和他的團隊正在努力改善一些可以改進的領域，包括關鍵供應商和製造網路的管理和彈性。

The recent stress of these global supply chain issues has further illuminated the need for the enhancements. We have a new global structure in place that consolidates operations and supply chain functions, which were previously fragmented throughout the organization. Now this is a big move for us.

近期全球供應鏈問題的壓力進一步凸顯了改進的必要性。我們已建立新的全球架構，整合了先前分散在整個組織中的營運和供應鏈職能。這對我們來說是一個重大舉措。

And there's still a lot of work to be done, but I am confident we will come out of this with a more resilient end-to-end global supply chain that we believe will be a competitive advantage in our industry.

雖然還有很多工作要做，但我相信我們將走出困境，建立更具彈性的端到端全球供應鏈，我們相信這將成為我們行業的競爭優勢。

While some of our Q4 challenges will persist in the near term, we expect strong improvement in the back half of our fiscal year, and we remain focused on delivering our long-term strategies. We have made significant changes over the past 2 years to position the company for accelerated and sustained innovation-driven growth.

雖然第四季度的部分挑戰短期內仍將持續存在，但我們預計本財年下半年將出現強勁改善，並將繼續專注於實施長期策略。過去兩年，我們進行了重大變革，旨在幫助公司實現加速且持續的創新驅動型成長。

Our pipeline is robust and continues to advance with a number of upcoming catalysts and fast-growing MedTech markets. We're committed to creating strong returns for our shareholders, and we're making progress with our enhanced portfolio management and our capital allocation processes. We're investing in future growth drivers, while at the same time returning capital primarily through our meaningful and growing dividend, which we just increased again today by 8%.

我們的產品線強勁，並隨著一系列新興催化劑和快速成長的醫療科技市場持續推進。我們致力於為股東創造豐厚回報，並在優化投資組合管理和資本配置流程方面取得進展。我們正在投資未來的成長動力，同時主要透過我們豐厚且不斷增長的股息來回報資本，今天我們剛剛再次將股息提高了8%。

Regarding portfolio management, we are continuing to advance the robust process we began talking about earlier this year. And within that, and as a smaller initial step, we're pleased to announce that we've reached an agreement where we will contribute our Renal Care Solutions business into a new company, which we will jointly own with DaVita.

關於投資組合管理，我們正在繼續推進今年稍早開始討論的穩健流程。在此基礎上，作為第一步，我們很高興地宣布，我們已達成協議，將把我們的腎臟護理解決方案業務注入一家新公司，我們將與DaVita共同擁有這家新公司。

And in return, we'll receive up to $400 million in value from them and we expect this transaction will close in calendar 2023. The new company is going to develop a broad suite of novel kidney care solutions, including home-based products.

作為回報，我們將從他們那裡獲得高達 4 億美元的價值，我們預計這筆交易將於 2023 年完成。新公司將開發一系列新型腎臟護理解決方案，包括家庭產品。

I'm excited about this for a couple of reasons. First, this business is going to have the focus that it needs. Second, DaVita is a global leader in kidney care and will be a great partner to commercialize and scale this innovative technology. And finally, both Medtronic and DaVita will participate in the expected upside.

我對此感到興奮，原因有幾個。首先，這項業務將獲得所需的關注。其次，DaVita是腎臟護理領域的全球領導者，將成為這項創新技術商業化和規模化的絕佳合作夥伴。最後，美敦力和DaVita都將分享預期的成長潛力。

Now turning to market share, product availability affected our performance in the quarter with our overall company share down about 0.5 point. On the bright side, even with our challenges, half of our businesses held or gained share. And as you know, market share is an important metric for us at Medtronic, as it is a driver of our annual variable compensation, along with revenue growth, profit and free cash flow. While I won't go through market share business by business in the interest of time, we'll be happy to take questions in Q&A.

現在談談市場份額，產品供應影響了我們本季的業績，導致我們公司整體市佔率下降了約0.5個百分點。值得慶幸的是，即使面臨挑戰，我們一半的業務仍保持或增加了市場份額。如您所知，市場佔有率對美敦力來說是一項重要指標，因為它是我們年度浮動薪資、收入成長、利潤和自由現金流的驅動因素。由於時間原因，我不會逐一介紹每個業務的市場份額，但我們很樂意在問答環節回答您的問題。

Now let's cover our product pipeline, where we're advancing several meaningful technologies that can create new markets, disrupt existing ones and accelerate the growth profile of Medtronic. We made great strides with our organic pipeline in fiscal '22, conducting over 300 clinical trials and receiving over 200 regulatory approvals in the U.S., Europe, Japan and China.

現在，我們來介紹一下我們的產品線。我們正在推動多項意義重大的技術，這些技術可以創造新的市場，顛覆現有的市場，並加速美敦力的成長。 22財年，我們的有機產品線取得了長足的進步，進行了300多項臨床試驗，並在美國、歐洲、日本和中國獲得了200多項監管部門的批准。

Our recent product launches are starting to make an impact across our businesses. And as we look ahead, we have increasing visibility to upcoming catalysts in the back half of the calendar year that we expect will help accelerate our growth as we go through fiscal '23 and beyond.

我們近期推出的產品已開始對我們的業務產生影響。展望未來，我們對下半年即將出現的催化劑的預見性越來越強，我們預計這些催化劑將有助於我們在2023財年及以後加速成長。

Starting with our cardiovascular portfolio and cardiac Rhythm Management, recently we launched leadless pacemakers, including our Micra AV in Japan and Micra VR in China led to above-market growth again this quarter. We just received approval for Micra AV in China earlier this month. And we expect geographic expansion to continue to drive strong Micra growth.

從心血管產品組合和心律管理開始，我們最近推出了無導線心律調節器，包括在日本推出的Micra AV和在中國推出的Micra VR，本季再次推動了高於市場的成長。本月初，我們剛剛在中國獲得了Micra AV的批准。我們預計地域擴張將繼續推動Micra的強勁成長。

In ICDs, we're preparing to disrupt the single-chamber market with our Aurora extravascular ICD. We continue to drive towards CE Mark approval for Aurora later this calendar year and U.S. approval next year. With Micra and EV ICD, we expect continued strength in CRM.

在ICD領域，我們正準備以Aurora血管外ICD顛覆單腔市場。我們將繼續努力，爭取Aurora在今年稍後獲得CE標誌認證，並於明年獲得美國認證。隨著Micra和EV ICD的推出，我們預期CRM市場將持續保持強勁成長。

In Cardiac Ablation Solutions, we've been assembling a number of technologies to increase our impact in the $8 billion EP ablation market, building on our leadership in cryoablation. We're continuing the rollout of our DiamondTemp RF system and exclusive cryoablation first-line indication for paroxysmal AF.

在心臟消融解決方案領域，我們一直在整合多項技術，以提升我們在價值 80 億美元的心電圖消融市場的影響力，並鞏固我們在冷凍消融領域的領先地位。我們將繼續推出 DiamondTemp 射頻系統以及針對陣發性心房顫動的第一線治療的獨家冷凍消融技術。

We're advancing our pulsed field [select] -- the anatomical pulsed field ablation system having fully enrolled our global pivotal trial. We're also expecting to fill competitive gaps in cardiac ablation with our recent announcements to add a differentiated mapping and navigation system and left heart access portfolio including a transseptal access system that can perform both mechanical and RF crossings.

我們正在推進脈衝場[部分]—解剖脈衝場消融系統，目前全球關鍵性試驗已全部入組。我們也期待透過近期宣布的新增差異化標測導航系統和左心室通路產品組合（包括可進行機械和射頻交叉的房間隔穿刺通路系統）來填補心臟消融領域的競爭空白。

In renal denervation, data from our SPYRAL HTN-ON MED pilot study were presented last month at ACC and simultaneously published in The Lancet. These data demonstrated durable and clinically significant blood pressure reductions through 3 years.

在腎臟去神經支配方面，我們SPYRAL HTN-ON MED先導研究的數據已於上個月在美國外科學會年會（ACC）上公佈，並同時發表於《柳葉刀》。這些數據表明，該療法在3年內可實現持久且具有臨床意義的血壓降低。

And last week, additional data were presented at EuroPCR which showed those receiving RDN spend significantly more time in target blood pressure range, adding to our robust body of evidence.

上週，EuroPCR 上公佈的額外數據顯示，接受 RDN 治療的患者在目標血壓範圍內停留的時間明顯更長，這進一步增強了我們有力的證據。

In Q4, we also announced that we completed enrollment in the full cohort of patients in the ON MED study, which we expect to complete the 6-month follow-up in the second half of this calendar year. We'll then look to present the data and submit for FDA approval as ON MED is the final piece of our submission.

第四季度，我們也宣布完成了 ON MED 研究的全部病患入組工作，預計今年下半年完成為期6個月的追蹤。之後，我們將提交資料並提交 FDA 審批，因為 ON MED 是我們提交申請的最後一部分。

In Structural Heart, differentiated durability data for our TAVR valves were presented as a late breaker at ACC last month. The data showed that our TAVR platform is the only one to outperform surgical valves and durability at 5 years as measured by SVD or structural valve deterioration. And less SVD was associated with better clinical outcomes, including mortality and heart failure hospitalization.

在結構性心臟領域，我們TAVR瓣膜的差異化耐久性數據於上個月在ACC年會上作為最新成果發布。數據顯示，我們的TAVR平台是唯一一款在5年耐久性方面超越外科瓣膜的平台，以SVD（結構性瓣膜損耗）為衡量標準。並且，較低的SVD與較好的臨床療效有關，包括死亡率和心臟衰竭住院率。

Additionally, durability data were presented from a separate U.K. registry, the first to look at TAVR data past 10 years. And it showed CoreValve had 1/3 the rate of structural valve deterioration compared to SAPIEN and SAPIEN XT.

此外，耐久性數據來自英國另一個註冊中心，該中心首次回顧了過去10年的TAVR數據。數據顯示，CoreValve的結構性瓣膜損壞率僅為SAPIEN和SAPIEN XT的三分之一。

And data at EuroPCR last week reinforced our excellent clinical outcomes with our cusp overlap implant technique, including 1-day hospital discharge, single-digit pacemaker rates and the absence of moderate or severe PVL.

上週 EuroPCR 的數據進一步證實了我們尖瓣重疊植入技術的出色臨床效果，包括 1 天出院、個位數起搏器植入率以及無中度或重度 PVL。

In the quarter, we also continued to launch Evolut PRO+ in Europe and began the launch of Evolut PRO in China, our first entry into this large and underpenetrated market. In the U.S. we're planning to start the limited market release of our next-generation TAVR valve, Evolut FX here in our first fiscal quarter and move into full market release later in the fiscal year.

本季，我們繼續在歐洲推出 Evolut PRO+，並開始在中國推出 Evolut PRO，這是我們首次進軍這個規模龐大且滲透率較低的市場。在美國，我們計劃在第一財季開始小規模上市我們的下一代 TAVR 瓣膜 Evolut FX，並在本財年晚些時候全面上市。

We're also looking to expand our TAVR indications. We had first enrollment earlier this month in our EXPAND TAVR II pivotal trial, evaluating our TAVR platform in patients with moderate symptomatic aortic stenosis. Overall, TAVR represents a large growth driver for Medtronic as we expect this roughly $5.5 billion market to exceed $7 billion within the next 3 years and reach $10 billion in the next 5 years.

我們也在尋求擴大TAVR的適應症。本月初，我們完成了EXPAND TAVR II關鍵試驗的首次患者入組，該試驗評估了我們的TAVR平台在中度症狀性主動脈瓣狹窄患者中的療效。整體而言，TAVR是美敦力的一大成長動力，我們預計這個約55億美元的市場將在未來3年內超過70億美元，並在未來5年內達到100億美元。

Moving to our Med Surg portfolio and Surgical Robotics, we remain focused on the limited market release of our Hugo robot while we scale production. We completed Hugo installations in Denmark, France and Italy. We also continue to increase our installed base of Touch Surgery Enterprise, our AI-powered surgical video and analytics platform.

談到我們的醫療外科產品組合和外科機器人，我們將繼續專注於Hugo機器人的有限市場投放，同時擴大生產規模。我們已經在丹麥、法國和義大利完成了Hugo的安裝。我們也將繼續擴大我們基於人工智慧的外科手術影片和分析平台Touch Surgery Enterprise的安裝基數。

In our Patient Monitoring business, we just received FDA clearance earlier this month for our next-generation Nellcor OxySoft pulse ox sensor. Now this sensor includes a special silicon adhesive designed to protect fragile skin while enhancing adherence. Its low profile and brighter LEDs improve accuracy and responsiveness for the most challenging neonatal and adult critical care patients.

在我們的病患監護業務方面，我們本月初剛獲得 FDA 批准新一代 Nellcor OxySoft 脈搏血氧感測器。這款感光元件採用特殊的矽膠黏合劑，旨在保護脆弱的皮膚，同時增強貼合性。其低調的外觀和更明亮的 LED 燈可提高準確性和響應速度，尤其適用於那些難以操作的新生兒和成人重症監護患者。

Now turning to our Neuroscience portfolio and our Cranial and Spinal Technologies business. We're seeing strong adoption of our unit AI-enabled surgical planning platform with a mid-30 sequential growth in our U.S. user base. The ongoing launch of our Catalyft Expandable Titanium Interbody System and the rollout of our enabling technologies continues to differentiate us in spine. Customer demand for our capital equipment remains strong. And we had record quarters for our Mazor robotics system and StealthStation Navigation System.

現在談談我們的神經科學產品組合以及顱腦和脊椎技術業務。我們看到我們基於人工智慧的手術規劃平台的採用率很高，美國用戶群環比增長了30%左右。 Catalyft可擴展鈦合金椎間融合系統的持續推出以及我們賦能技術的推廣，繼續使我們在脊椎領域保持差異化。客戶對我們資本設備的需求依然強勁。我們的Mazor機器人系統和StealthStation導航系統也創下了季度業績紀錄。

In Neuromodulation, we're building our commercial teams and have started the initial launch of our Intellis and Vanta spinal cord stimulators to treat diabetic peripheral neuropathy. We believe DPN is one of the largest opportunities in Med Tech, and we expect the market to reach $300 million by FY '26 with an annual total addressable market of up to $2 billion.

在神經調節領域，我們正在組建商業團隊，並已開始首次推出用於治療糖尿病週邊神經病變的Intellis和Vanta脊髓刺激器。我們認為糖尿病週邊神經病變（DPN）是醫療科技領域最大的機會之一，預計到2026財年，該市場規模將達到3億美元，年潛在市場總額將高達20億美元。

And we're also excited about our Inceptiv ECAPs closed-loop spinal cord stimulator, which we submitted to the FDA late last calendar year. We expect Inceptiv's closed-loop therapy, which optimizes pain relief for patients to revolutionize the SCS market.

我們也對Inceptiv ECAPs閉環脊髓刺激器感到興奮，該刺激器已於去年底提交給FDA。我們期待Inceptiv的閉環療法能夠優化患者的疼痛緩解，從而徹底改變脊髓刺激市場。

In brain modulation, our ongoing launch of the Percept PC neurostimulator and SenSight Directional Leads is driving new implant share in both Europe and the U.S. And this is the only system that can stimulate and sense brain signals.

在腦調節方面，我們正在推出的 Percept PC 神經刺激器和 SenSight Directional Leads 正在推動歐洲和美國新的植入物份額。這是唯一可以刺激和感知腦部訊號的系統。

In Pelvic Health, we received FDA approval of our next-gen InterStim recharge-free device, InterStim X, and that was happened in the fourth quarter. InterStim X features our proprietary fifth-generation battery chemistry that provides 10 to 15 years of battery life without the need to recharge.

在骨盆腔健康領域，我們的下一代InterStim免充電設備InterStim X已於第四季度獲得FDA批准。 InterStim X採用我們專有的第五代電池化學技術，無需充電即可提供10至15年的電池壽命。

And in ENT, we announced earlier this month that we completed the acquisition of Intersect ENT. And we're excited to add their attractive high-growth complementary products into our existing business. We believe we can grow Intersect's products in the double digits over the next several years as we expand use of both the PROPEL and SINUVA sinus implants globally.

在耳鼻喉領域，我們本月初宣布完成對 Intersect ENT 的收購。我們很高興能將其極具吸引力的高成長互補產品添加到我們現有的業務中。我們相信，隨著 PROPEL 和 SINUVA 鼻竇植入物在全球範圍內的推廣，Intersect 的產品在未來幾年內能夠實現兩位數的成長。

In Diabetes, our MiniMed 780G insulin pump, combined with our Guardian 4 Sensor continues to be extremely well received in markets where it's available. Now this system has a very positive user experience with no fingersticks and more time and range. This is due to its near real-time basal insulin and auto correction boluses every 5 minutes to address underestimated carbohydrate counts and occasional missed meal doses. Very strong data on 780G and Guardian 4 were presented at ATTD last month, showing improved time and range with less user interaction. Additional data sets on this differentiated system will be shared at ADA next month.

在糖尿病領域，我們的 MiniMed 780G 胰島素幫浦與 Guardian 4 感測器的結合，在其上市的市場持續受到熱烈歡迎。現在，該系統擁有非常積極的用戶體驗，無需指尖採血，並擁有更長的測量時間和更大的測量範圍。這要歸功於其近乎即時的基礎胰島素和每 5 分鐘自動校正一次的推注劑量，以解決碳水化合物攝取量低估和偶爾漏服的情況。上個月在 ATTD 上展示了 780G 和 Guardian 4 的出色數據，顯示其測量時間和測量範圍有所提升，且用戶互動更少。下個月，我們將在 ADA 上分享更多關於這款差異化系統的資料集。

And we also announced that Germany and France began reimbursement of our system in the quarter, which helped drive high-teens sequential international growth in diabetes. And in the U.S., we made substantial progress in meeting our observation and warning letter commitments, and continue to have regular communication with the FDA.

我們也宣布，德國和法國在本季開始報銷我們的系統，這有助於推動全球糖尿病患者數量實現環比高十幾個百分點的成長。在美國，我們在履行觀察函和警告信承諾方面取得了實質進展，並繼續與FDA保持定期溝通。

In our CGM pipeline, we expect to submit our next-generation sensor, Simplera, for CE Mark and FDA approval this summer. In addition, we're advancing multiple next-gen sensor and pump programs, including patch pumps. We're making considerable investments in our diabetes pipeline with line of sight to restoring strong growth in this business over the coming years.

在我們的動態血糖監測 (CGM) 產品線中，我們預計將於今年夏天提交下一代感測器 Simplera 的 CE 標誌和 FDA 批准。此外，我們正在推進多個下一代感測器和泵浦項目，包括貼片泵浦。我們正在大力投資糖尿病產品線，力求在未來幾年恢復該業務的強勁成長。

And with that, I'll turn it over to Karen to discuss our fourth quarter financial performance, and our new guidance for the next fiscal year, Karen?

接下來，我將把時間交給 Karen 來討論我們第四季度的財務業績，以及我們對下一財年的新指導，Karen？

Thank you, Geoff. Our fourth quarter organic revenue increased 1.4% below our guidance and consensus. Compared to consensus, about 15% of the difference can be attributed to China, given recent COVID shutdowns and slowing distributor purchases in spine ahead of a potential national volume-based tender.

謝謝，Geoff。我們第四季的有機收入成長了1.4%，低於我們的預期和共識。與共識相比，約15%的差異可歸因於中國市場，原因是近期新冠疫情導致的停工，以及在可能進行的全國性批量招標之前，分銷商在脊柱方面的採購有所放緩。

About 10% of the difference is a result of changes in foreign exchange rates over the course of the quarter. And the remaining difference and the largest driver is due to supply chain issues that Geoff discussed.

其中約10%的差異是本季外匯匯率變動所造成的。其餘差異，也是最大的驅動因素，是Geoff提到的供應鏈問題。

Despite revenue coming in roughly $350 million less than we expected, we reduced the impact that this would have had on our bottom line, resulting in EPS of $1.52, $0.04 below our guidance range.

儘管收入比我們預期的少了約 3.5 億美元，但我們減少了這對我們底線的影響，導致每股收益為 1.52 美元，比我們的指導範圍低 0.04 美元。

From a geographic perspective, our U.S. revenue declined 2%. Non-U.S. developed markets grew 4% and our emerging markets grew 7%. Within emerging markets, China declined 10%, given the impact of the COVID lockdowns. But we had very strong growth in many other emerging markets, including high teens growth in Eastern Europe, low 20s growth in Latin America, low 30s growth in the Middle East and Africa, and mid-30s growth in South Asia. In fact, excluding China, emerging markets grew in the low 20s.

從地域角度來看，我們在美國的收入下降了2%。美國以外的已開發市場成長了4%，新興市場成長了7%。在新興市場中，受新冠疫情封鎖的影響，中國市場下降了10%。但我們在許多其他新興市場實現了強勁成長，包括東歐約15%的成長率，拉丁美洲約20%的成長率，中東和非洲30%左右的成長率，以及南亞約30%的成長率。事實上，除中國外，新興市場的成長率都在20%左右。

Turning to our margins, our fourth quarter adjusted gross margin improved by 30 basis points year-over-year, driven by product mix with lower sales of ventilators and higher sales of products like Micra. While we were impacted by inflation with increased freight expense, it's worth noting that the full impact from inflation on raw material and direct labor costs will be realized over the next couple of quarters as our inventory rolls off our balance sheet, negatively affecting our gross margin.

談到我們的利潤率，第四季調整後毛利率年增30個基點，這得益於產品組合的改善，呼吸器銷量下降，而Micra等產品銷量上升。雖然我們受到了通貨膨脹的影響，運費上漲，但值得注意的是，通貨膨脹對原材料和直接人工成本的全面影響將在未來幾季顯現，因為我們的庫存將從資產負債表中減少，從而對我們的毛利率產生負面影響。

Moving down to P&L, we also drove additional and continued improvement in our adjusted operating margin, which increased by 40 basis points, excluding the benefit from currency. We also ended the year with free cash flow at $6 billion, representing year-over-year growth of 22% and meeting our goal of 80% conversion from adjusted net income.

再來看損益表，我們的調整後營業利益率也進一步提升，不計匯率變動的影響，成長了40個基點。年末，我們的自由現金流達到60億美元，年增22%，實現了調整後淨收入轉換率80%的目標。

Our balance sheet remained strong, and we continue to allocate our capital to investments that we expect will generate solid future growth and shareholder returns. We're investing heavily in R&D, with programs especially targeted for faster-growing Med Tech markets or where we have an opportunity to create new markets. We're also using our balance sheet to complement our innovation-driven growth strategy with tuck-in M&A, utilizing our very active capital committee process that was developed as part of our new operating model.

我們的資產負債表依然強勁，我們持續將資本配置於那些我們預期將帶來穩健未來成長和股東回報的投資。我們正在大力投資研發，並特別針對成長較快的醫療科技市場或我們有機會開拓新市場的項目。我們也利用我們的資產負債表，透過整合併購來補充我們創新驅動的成長策略，並利用我們作為新營運模式一部分而開發的非常活躍的資本委員會流程。

In fiscal '22, we announced 4 acquisitions totaling over $2.1 billion in total consideration. As Geoff mentioned, we closed our acquisition of Intersect ENT earlier this month, and also announced our intent to acquire a left heart access portfolio last month. At the same time, we're investing in promising early-stage ventures to keep our fingers on the pulse of new products and technologies, incubated by companies that one day could become future acquisitions.

在22財年，我們宣布了四項收購，總金額超過21億美元。正如Geoff所提到的，我們本月初完成了對Intersect ENT的收購，並在上個月宣布了收購左心室介入業務的意向。同時，我們正在投資一些前景看好的早期創業公司，以隨時掌握新產品和新技術的動態，這些公司孵化的新產品和新技術未來可能成為我們的收購對象。

We're also actively providing strong return to our shareholders, returning $5.5 billion in fiscal '22 through our dividend and net share repurchase. And this morning, we announced that we're increasing our dividend by 8%, reflecting the confidence we and our Board have in our financial strength and future earnings power.

我們也積極為股東提供豐厚回報，22財年透過股利和淨股票回購回報了55億美元。今天上午，我們宣布將股息提高8%，這反映了我們和董事會對我們財務實力和未來獲利能力的信心。

We are an S&P Dividend Aristocrat, having increased our dividend for 45 years now, and our dividend is an important component of the total return we generate for our shareholders. This past year, we paid $3.4 billion in dividends and we're supplementing that through opportunistic share repurchase, particularly in periods where we see share price dislocation. In fact, we repurchased over 2.5 billion of our stock in fiscal '22, including 1.4 billion in the fourth quarter.

我們是標普股息貴族，45年來一直保持股息成長，股息是我們為股東創造的總回報的重要組成部分。去年，我們支付了34億美元的股息，我們透過機會性股票回購來補充，尤其是在股價波動的時期。事實上，我們在22財年回購了超過25億股股票，其中第四季回購了14億股。

Now turning to our guidance and starting with revenue, we continue to expect our recent launches and product pipeline to make a difference in many of our businesses, and Geoff covered many of them earlier. We expect organic revenue growth in fiscal '23 of 4% to 5%. While the impact of currency is fluid, if recent exchange rates hold, foreign currency would have a negative impact on full year revenue of $1 billion to $1.1 billion.

現在談談我們的業績指引，先從收入開始。我們仍然預計近期發布的新產品和產品線將對我們的許多業務產生影響，Geoff 之前已經介紹了其中的許多業務。我們預計 23 財年的有機收入成長率將達到 4% 至 5%。雖然匯率的影響不穩定，但如果近期匯率保持不變，外幣波動將對全年收入造成 10 億至 11 億美元的負面影響。

By segment, we expect Cardiovascular to grow 5.5% to 6.5%; Medical Surgical to grow 3.5% to 4.5%; Neuroscience to grow 5% to 6%; and Diabetes to decline 6% to 7%, all on an organic basis. While we are hopeful that we can receive approval for 780G and Guardian 4 Sensor in the United States, we've elected not to include it in our guidance.

以細分市場來看，我們預期心血管領域將成長 5.5% 至 6.5%；外科手術領域將成長 3.5% 至 4.5%；神經科學領域將成長 5% 至 6%；糖尿病領域將下降 6% 至 7%，所有成長均為內生成長。雖然我們對 780G 和 Guardian 4 Sensor 能夠在美國獲得批准抱有希望，但我們選擇不將其納入我們的業績指引。

In the first quarter, we would have you model organic revenue to decline in the range of 4.5% to 5.5%, which conservatively assumes no near-term improvement in our supply chain and no major change to underlying fundamentals.

在第一季度，我們預計有機收入將下降 4.5% 至 5.5%，這保守地假設我們的供應鏈短期內不會改善，基本面也不會發生重大變化。

Assuming recent exchange rates hold, the first quarter would have a currency headwind between $350 million and $400 million. By segment, we expect Cardiovascular to decline 1% to 2%; Medical Surgical to decline 7.5% to 8.5%; Neuroscience to be down 5% to 6%; and Diabetes down 8% to 10%, all on an organic basis.

假設近期匯率維持不變，第一季將面臨3.5億至4億美元的貨幣逆差。以細分市場來看，我們預期心血管疾病業務將下降1%至2%；外科手術業務將下降7.5%至8.5%；神經科學業務將下降5%至6%；糖尿病業務將下降8%至10%，所有業務均為內生性成長。

Moving down the P&L, I provided early color for fiscal '23 on the last quarterly earnings call, where I talked about the expected impact of inflation, wages, acquisition dilution and foreign exchange headwinds. These still hold, but we've also seen environmental changes since late February.

繼續看損益表，我在上次季度財報電話會議上對2023財年進行了初步展望，當時我談到了通貨膨脹、工資、收購稀釋和外匯逆風的預期影響。這些因素仍然存在，但自2月底以來，我們也看到了環境的變化。

Inflation and foreign exchange rates have become larger headwinds, and we're now factoring in continued supply chain challenges early in the year. Inflation and FX pressures also create near-term challenges on our margins, although we continue to look for opportunities to offset them.

通膨和匯率已成為更大的阻力，我們目前已將年初持續的供應鏈挑戰納入考量。通貨膨脹和匯率壓力也為我們的利潤率帶來了短期挑戰，儘管我們仍在繼續尋找機會來抵消這些影響。

At the same time, we continue to prioritize our long-term investments in organic R&D, with a focus on large opportunities in future growth markets, like renal denervation, robotics, diabetic peripheral neuropathy and transcatheter mitral valves.

同時，我們繼續優先考慮對有機研發的長期投資，重點關注未來成長市場中的重大機遇，如腎臟去神經支配、機器人技術、糖尿病週邊神經病變和經導管二尖瓣。

Taking this all into account on the bottom line, we expect non-GAAP diluted EPS in the range of $5.53 to $5.65 in fiscal '23, which includes an unfavorable impact of $0.20 to $0.25 from currency at recent rates, for the first quarter, we expect EPS of $1.10 to $1.14, including an FX headwind of about $0.05 at current rates.

綜合考慮這些因素，我們預計 23 財年非 GAAP 稀釋每股收益將在 5.53 美元至 5.65 美元之間，其中包括近期匯率帶來的 0.20 美元至 0.25 美元的不利影響。對於第一季度，我們預計每股收益為 1.10 美元至 1.14 美元，其中包括當前匯率約 0.05 美元的外匯逆風。

Before I send it back to Geoff, I want to thank our employees around the globe who are working hard to overcome the macro challenges we face. Thanks for all you do to fulfill our mission every day. Back to you, Geoff.

在轉交給傑夫之前，我想感謝我們遍布全球的員工，他們正在努力克服我們面臨的宏觀挑戰。感謝你們每天為完成我們的使命所做的一切。傑夫，回敬你！

Thank you, Karen. While we spent a lot of time covering the fourth quarter, it's worth briefly reflecting on what we've accomplished in fiscal '22. It's certainly been a difficult environment, and our organization has enacted big changes in such a short period of time and under unique circumstances to better position the company.

謝謝你，凱倫。雖然我們花了很多時間回顧第四季度，但還是值得簡單回顧一下我們在2022財年的成就。這無疑是一個艱難的環境，我們公司在如此短的時間內，在特殊的情況下實施了重大變革，以使公司更好地定位。

It was our first full year in the new operating model, and with our enhanced Medtronic mindset of acting boldly, competing to win, moving with speed and decisiveness, fostering, belonging and delivering results the right way. We've also made strides to becoming a more diverse and inclusive organization.

這是我們採用全新營運模式的第一個完整年度，美敦力的理念得到了進一步強化：大膽行動、競爭取勝、快速果斷地行動、培養歸屬感並以正確的方式交付成果。我們也朝著更多元化和包容性的組織邁進。

And I was very proud that Medtronic was recognized earlier this month as #10 on Diversity Inc.'s Top 50 U.S. Companies for Diversity. Even with that, we're committed to improving through innovative programs to attract, develop and retain top talent from all gender and ethnic backgrounds. Along those lines, we've made notable hires in fiscal '22, recruiting great talent from health care technology industry and beyond.

本月早些時候，美敦力在 Diversity Inc. 評選的美國多元化公司 50 強中排名第 10，我對此深感自豪。即便如此，我們仍致力於透過創新計畫不斷改進，以吸引、培養和留住來自不同性別和種族背景的頂尖人才。為此，我們在 22 財年進行了一系列引人注目的招聘，從醫療技術行業及其他領域招募了許多優秀人才。

While we've implemented a number of changes, this past year has been choppier than I would have liked with some of our growth drivers being pushed out and the impact from the pandemic, quality challenges and supply chain affecting our results. But we have a clear direction -- a clear direction where we're headed as we transform the company.

雖然我們實施了一系列變革，但過去的一年比我預想的要坎坷得多，一些成長動力被擠出市場，疫情、品質挑戰和供應鏈也影響了我們的業績。但我們的方向很明確──在公司轉型過程中，我們前進的方向很明確。

Let's start with the top line. We remain laser-focused on accelerating the growth through robust capital allocation and portfolio management. You're seeing our efforts to enhance our future growth through greater investment in organic R&D, as well as portfolio moves.

讓我們先從營收開始。我們將繼續專注於透過穩健的資本配置和投資組合管理來加速成長。您已經看到，我們正在努力透過增加對有機研發的投資以及投資組合的調整來提升未來的成長。

We've already spoken of the organic growth catalysts in front of us, many coming later this fiscal year. We're also executing a healthy cadence of tuck-in acquisitions in faster-growing markets, and we're focused on reducing our footprint in lower growth and lower-margin businesses.

我們已經談到了我們面臨的有機成長催化劑，其中許多將在本財年晚些時候推出。我們也在快速成長的市場中以健康的步調進行補充收購，並專注於減少我們在低成長、低利潤業務中的足跡。

We continue to work on additional portfolio moves with the goal of creating a portfolio where we have distinct expertise, synergies across the company and ultimately, higher growth and higher margins. And to aid this effort, we've assembled a dedicated team that is 100% focused on our integrations and divestitures.

我們將繼續致力於進一步調整投資組合，目標是打造一個擁有獨特專長、公司協同效應、並最終實現更高成長和更高利潤率的投資組合。為了實現這一目標，我們組建了一支100%專注於整合和剝離的專職團隊。

At the same time, we have the opportunity to improve our global supply chain and operations by centralizing these activities, allowing us to leverage our scale, invest in new technology and ensure we have world-class supply chain experts responsible for our global operations.

同時，我們有機會透過集中這些活動來改善我們的全球供應鏈和運營，使我們能夠利用我們的規模，投資新技術並確保我們擁有負責全球運營的世界級供應鏈專家。

And this isn't something new that we're just starting now. Although recent challenges have given us a greater sense of urgency, we've been on this journey for over a year. And while it will take time, I fully expect our efforts to drive lower cost and lead to consistent and reliable quality along with greater product availability, all on a sustainable basis.

這並不是我們剛開始的新事物。儘管最近的挑戰讓我們更加緊迫，但我們已經踏上這條旅程一年多了。雖然這需要時間，但我完全相信我們的努力能夠降低成本，帶來一致、可靠的質量，以及更高的產品供應，所有這些都是可持續的。

Now well beyond health care, our world is facing a lot of economic uncertainty with questions around inflation, global supply chain challenges and continued impacts from the pandemic and a potential recession. But our business, the business of health care and the delivery of essential life-saving technology is something that continues in good times and uncertain times like these. And demand for our products continues to increase with the aging and growing of our global population.

如今，除了醫療保健領域，我們的世界還面臨著許多經濟不確定性，包括通貨膨脹、全球供應鏈挑戰以及疫情和潛在經濟衰退的持續影響。但我們的業務，醫療保健業務以及提供至關重要的救生技術，無論在順境還是在當前這種充滿不確定性的時期，都將持續發展。隨著全球人口老化和成長，對我們產品的需求也持續增長。

When you look at health care technology, Medtronic is uniquely situated, particularly in these uncertain times, given our diversified businesses with leading market positions in growth markets, a robust product pipeline, solid free cash flow, strong balance sheet, and a very attractive and growing dividend to add to our return to shareholders.

當你看醫療保健技術時，美敦力處於獨特的地位，特別是在這些不確定的時期，因為我們的業務多元化，在成長市場中佔據領先地位，擁有強大的產品線、穩健的自由現金流、強勁的資產負債表以及非常有吸引力且不斷增長的股息，從而增加了我們對股東的回報。

We have near-term challenges that we are overcoming, and the opportunities in health care technology and at Medtronic are immense. We are fully focused on continuing on our transformation journey and making our opportunities a reality as we alleviate pain, restore health and extend life for millions of people around the world.

我們正在克服近期的挑戰，醫療科技領域以及美敦力的機會也同樣巨大。我們正全力以赴，繼續推動轉型之旅，將機會轉化為現實，為全球數百萬患者減輕病痛、恢復健康、延長壽命。

Finally, I want to thank our exceptional Medtronic employees. I get to see the outcome of their efforts to fulfill our mission every day. It's inspiring. In addition, their willingness to lean into our new operating model and embrace our new culture have been key to the ongoing transformation of the company.

最後，我要感謝我們傑出的美敦力員工。我每天都能看到他們為完成我們的使命所付出的努力成果。這令人鼓舞。此外，他們願意融入我們新的營運模式並擁抱新的文化，這對公司持續轉型至關重要。

I also want to thank our partners in health care, the frontline workers who are at that final step in ensuring patients get our therapies and are dedicating their lives day in and day out. Their incredible efforts to continue care delivery and get us all through the pandemic will be noted as one of the great accomplishments in history.

我還要感謝我們在醫療領域的合作夥伴，感謝那些在最後一線、日復一日奉獻生命、確保病人獲得治療的醫護人員。他們為繼續提供醫療服務、幫助我們所有人度過疫情所做的非凡努力，將被載入史冊，成為偉大的成就之一。

Now let's move to Q&A. We're going to try to get as many analysts as possible, so we ask that you limit yourself to just one question and only if needed, a related follow-up. If you have additional questions, you can reach out to Ryan and the Investor Relations team after the call.

現在我們進入問答環節。我們會盡可能邀請分析師，因此請您只提問一個問題，並且僅在必要時進行相關的後續問題。如果您還有其他問題，可以在電話會議結束後聯繫 Ryan 和投資者關係團隊。

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

布拉德，您能否給予提問的說明？

(Operator Instructions) Today's Q&A session is being recorded. For today's session, Geoff, Karen and Ryan are joined by Sean Salmon, EVP and President of the Cardiovascular portfolio and former Head of the Diabetes Operating Unit; Bob White, EVP and President of the Medical Surgical portfolio; and Brett Wall, EVP and President of the Neuroscience portfolio. (Operator Instructions) We'll take the first question from Vijay Kumar at Evercore ISI.

（操作員指示）今天的問答環節正在錄製中。今天的問答環節，除了Geoff、Karen和Ryan之外，還有心血管產品組合執行副總裁兼總裁、前糖尿病營運部門負責人Sean Salmon、外科產品組合執行副總裁兼總裁Bob White以及神經科學產品組合執行副總裁兼總裁Brett Wall。 （操作員指示）第一個提問者是Evercore ISI的Vijay Kumar。

Geoff and Karen, maybe I had a 2-part question. I'll ask both right away. When I look at the 4% to 5% organic guide for fiscal '23, perhaps it came in slightly better than expected. Can you talk about some specific assumptions around even -- you noted supply chain, there were some back orders. Is there some contribution from supply chain back orders? Any further disruption from supply chain? What are you assuming for diabetes, robotics?

傑夫和凱倫，我的問題可能分為兩部分。我馬上就問。我查看了2023財年4%到5%的有機成長預期，可能比預期略好。您能否談談一些具體的假設——您提到了供應鏈，當時有一些積壓訂單。供應鏈積壓訂單有貢獻嗎？供應鏈是否會進一步中斷？您對糖尿病和機器人技術有何假設？

I think China VBP something that investors have asked. And Geoff, related to that, I think, if I take a step back, the Medtronic pieces of mid-singles top high singles earnings. Consistency has been something that people have questioned. We've had some moving parts over the years.

我認為中國VBP是投資者關心的問題。 Geoff，與此相關，我認為，如果我退一步來看，美敦力的中單業務獲利高於高單業務。一致性一直是人們質疑的。這些年來，我們經歷了一些波動。

As you look at all the changes that have happened, -- maybe talk about what gives you the confidence that this consistency of mid-singles on the top and high singles on the EPS line should be something that investors should look forward to?

當您看到所有發生的變化時，也許可以談談是什麼讓您有信心相信這種頂部中等單數和 EPS 線上高單數的一致性應該是投資者應該期待的事情？

Sure. Well, let me -- thanks for the question Vijay, maybe I'll take the second part of that question, and then Karen can take the first part of the details behind the 4% to 5% for FY '23. But on the second part in terms of the confidence of getting back to -- getting to that constant mid-single-digit currency top line and high single-digit EPS growth or double-digit total return to shareholders. I do think we're putting the right things in place.

當然。好吧，謝謝Vijay的提問，我來回答這個問題的第二部分，然後Karen可以回答第一部分關於2023財年4%到5%的增長率背後的細節。至於第二部分，我指的是我們是否有信心實現——持續維持中等個位數的貨幣收入成長、高個位數的每股盈餘成長或兩位數的股東總回報率。我確實認為我們正在採取正確的措施。

So first of all, just over the next -- Karen can detail this, but over the next year, you'll see the acute back order issues that we faced in Q4. Those abate over the next quarter or so, and we can get into the details of that. In addition, we're definitely anniversarying a lot of things that hurt us in FY '22, like exiting the LVAD business, the Navion recall, some tough comps on our ventilator business during the height of the pandemic. So these things abate over -- these things go away over the course of the fiscal year and you're starting now, actually.

首先，接下來的一年——Karen 可以詳細說明一下，但接下來的一年，我們將看到我們在第四季度面臨的嚴重訂單積壓問題。這些問題會在下個季度左右緩解，我們可以詳細討論。此外，我們肯定會在 2022 財年紀念許多對我們造成影響的事情，例如退出 LVAD 業務、Navion 召回事件，以及疫情高峰期呼吸機業務的一些糟糕表現。所以，這些問題會逐漸緩解──這些情況會隨著財年的發展而消失，實際上，現在就開始了。

And then finally, we've got a lot of growth catalysts. We've talked a lot about the pipeline and I can go through that. There's a long list. I went through a lot of it in the commentary, but it's much broader than like the Hugo or our soft tissue robot, in RD. And those are big ones, but there's a whole lot of other ones as well.

最後，我們有很多成長催化劑。我們已經討論了很多關於產品線的事情，我可以一一列舉。清單很長。我在評論中已經講了很多，但它的範圍比Hugo或我們的軟組織機器人（研發）要廣泛得多。這些都是重要的催化劑，但還有很多其他的催化劑。

And then -- so that -- those things kick in, in the second half of this year and then get even bigger in FY '24. And then finally, we've got some portfolio moves that over the next year or so, I think we'll -- that will add to this. So that's how we get from where we are to back to that, the numbers that you quoted.

然後——這樣——這些因素會在今年下半年開始顯現，並在2024財年進一步增強。最後，我們將在未來一年左右調整投資組合，我認為這些調整將會進一步增強。這就是我們從目前的狀況到你引用的數字的過程。

And then the second part of your question gets to kind of the confidence and the consistency. And I'd say there are 2 things. One is having this robust pipeline spread across all of our businesses. And we've been working hard over the last couple of years to double down on our innovation, putting more into R&D, the new operating model that we have the 20 operating units, we have a clear visibility into their end markets, their competition, people are getting evaluated on their pipeline.

你問題的第二部分是關於信心和一致性的。我想說有兩點。第一，我們擁有覆蓋所有業務的強大產品線。過去幾年，我們一直在努力加倍創新，並加大研發投入。新的營運模式，我們擁有20個營運部門，我們對他們的終端市場和競爭對手有著清晰的了解，員工也會根據他們的產品線進行評估。

And we're putting more into R&D and as well as some meaningful tuck-in acquisitions, like we just mentioned Intersect ENT closing and in the Cardiac Ablation Solutions space or the AFib space, the Affera acquisition. These are meaningful adds. So I get -- that gives us diversity and more growth on the top line.

我們在研發方面投入了更多資金，同時也進行了一些意義重大的補充性收購，例如我們剛才提到的Intersect ENT的關閉，以及在心臟消融解決方案領域和心房顫動領域收購Affera。這些都是意義重大的補充。所以，我明白，這讓我們的業務更加多元化，營收也獲得了更大的成長。

But the piece that we really have been focusing on over the last year and is important for our future in terms of consistency is the global operations and supply chain changes that we made. These are -- coming into this role, myself and the team identified this as an opportunity for us, brought in Greg Smith, as we mentioned in the commentary over a year ago and really already centralized our supply chain.

但過去一年我們真正關注的、對我們未來保持一致性至關重要的是我們所做的全球營運和供應鏈變革。在擔任這個職位之前，我和團隊認為這是一個機遇，我們引入了格雷格史密斯，正如我們一年前在評論中提到的那樣，實際上已經實現了供應鏈的集中化。

Our global ops and supply chain was really set up for a different era, a pass there. And we had to make those changes. And unfortunately, they haven't fully taken hold yet, they need more time to mature. I would have liked to have this -- those moves done earlier. It definitely would have helped in Q4 because the supply chain issues came out fast and hard and especially in the back half of the quarter more supplier decommits than we've ever seen.

我們的全球營運和供應鏈實際上是為一個不同的時代而設立的，它已經過時了。我們必須做出這些改變。不幸的是，這些改變還沒有完全生效，需要更多時間才能成熟。我本來希望這些改變能早點完成。這肯定會對第四季度有所幫助，因為供應鏈問題來得又快又猛，尤其是在本季後半段，供應商的退出數量比以往任何時候都多。

But the good news is that we're not just getting started on this transformation of supply chain. I'd hate to be starting it now in the middle of this environment. We're well down the path and to building in that resiliency. We've made these moves and we're confident that these changes will give us that resiliency that we need and that dependability.

但好消息是，我們供應鏈轉型並非才剛開始。我不希望在這種環境下才開始。我們已經在這條路上走得很遠，並且正在建立這種韌性。我們已經採取了這些舉措，並且相信這些變革將賦予我們所需的韌性和可靠性。

So the combination of the innovation, plus some portfolio moves and just a more resilient global ops and supply chain. That's how we're confident that we get to the long-range forecast that we talked about of consistent mid-single digits, that 5% plus, including the plus and the high single-digit EPS when you add in the dividend gives you a double-digit return.

因此，創新、投資組合調整以及更具韌性的全球營運和供應鏈相結合，讓我們有信心實現我們先前提到的長期預測，即持續保持中等個位數的成長率。如果加上股息，加上5%以上的高個位數每股盈餘，就能帶來兩位數的報酬。

But in terms of -- I hope I answered that question. Karen can add to it. But in terms of the FY '23 guide and the details below that, I'll turn that over to Karen.

但就……我希望我回答了這個問題。 Karen 可以補充。至於 2023 財政年度指南及其後續細節，我將交給 Karen 處理。

Yes, thanks, Vijay, for the question, and I'd love to take this in pieces because I want to walk you through Q1 and then also talk about the full year because we expect improvement each quarter as we move through the year. So just starting with Q1, given our recent challenges, we've elected to take a conservative approach with our Q1 guide.

是的，Vijay，謝謝你的提問。我想把這個問題分成幾個部分來討論，因為我想先介紹一下第一季度的情況，然後再談談全年的情況，因為我們預計全年每個季度都會有所改善。所以，從第一季開始，考慮到我們最近面臨的挑戰，我們選擇對第一季的業績指引採取保守的態度。

We're assuming underlying fundamentals are pretty similar to last quarter to Q4, and we've built in some conservatism in the supply chain. If you look at the year-over-year view, it's influenced by COVID. And so to remove that noise, I think it's really good to look at it on a COVID comp-adjusted basis. And when you do that, our guide really just implies a slight deceleration from Q4 to Q1. That's not out of line with what we've seen historically. And again, I would just emphasize that we've included conservatism due to the supply chain.

我們假設基本面與上一季至第四季基本相似，並且我們在供應鏈方面也採取了一些保守的策略。如果從同比來看，會發現它受到了新冠疫情的影響。因此，為了消除這些幹擾，我認為最好以新冠疫情調整後的數據為基礎進行分析。這樣一來，我們的預測實際上只是暗示了從第四季到第一季的略微減速。這與我們過去的經驗並無二致。再次強調，我們已將供應鏈的保守因素納入考量。

Some puts and takes that we've got in Q1, in addition to the supply chain impact that we factored in, we've also assumed some incremental pressure in Spine in China ahead of a potential national volume-based purchasing tender. And Geoff already mentioned on the plus side, we anniversary some of our headwinds like the Navion recall and the LVAD shutdown.

我們在第一季遇到了一些利弊，除了我們已經考慮的供應鏈影響之外，我們還預計在潛在的全國批量採購招標之前，Spine 在中國市場將面臨一些增量壓力。 Geoff 已經提到，積極的一面是，我們經歷了一些逆境，例如 Navion 召回和 LVAD 停產。

If I move beyond Q1 and then into the full year guide of the 4.5%, I mentioned we do expect improvement as we progress through the quarters with our back half much better than our first half. But I'd also talk about the puts and takes that we've got on the full year. We talked about the fact that we continue to actively work with the FDA on the diabetes warning letter.

如果我把目光投向第一季之後，然後是全年4.5%的預期成長，我提到我們確實預計隨著季度的推進，下半年的業績會比上半年好得多。但我也會談談我們全年的得失。我們談到了我們將繼續積極與FDA合作，處理糖尿病警告信的問題。

But for conservatism, we've elected not to assume the approval of the 780G in this guidance. And also, it's manageable, but we've got volume-based pricing in China that we believe will have a bigger impact in this fiscal year, primarily in Spine.

但出於保守考慮，我們選擇不在本指引中假設780G獲得批准。此外，這是可控的，但我們在中國有批量定價，我們認為這將對本財年產生更大的影響，主要是在Spine方面。

And at the same time, Geoff talked about it, and we have a number of positives as we think about FY '23. First, we've got headwinds that are going to go away, the LVAD business, the Navion recall, the reduced ventilator sales that Geoff mentioned. And then we also had some volume-based pricing on drug-eluting stents in China that will anniversary. And combined, all of those headwinds had a 200 basis point impact in FY '22.

同時，正如Geoff所言，我們在展望23財年時也看到了一些正面的訊號。首先，我們面臨的一些不利因素即將消退，例如左心室輔助裝置（LVAD）業務、Navion召回事件以及Geoff提到的呼吸機銷售下滑。此外，中國市場藥物洗脫支架的批量定價也將迎來週年紀念。所有這些不利因素加在一起，對22財年的影響達到了200個基點。

Second, we expect these supply chain challenges to improve as starting in Q2 and obviously continuing to improve from there.

其次，我們預計這些供應鏈挑戰將從第二季開始改善，並且顯然會持續改善。

And then thirdly, our year-over-year comps get easier, particularly in the back half. And then lastly, we've got a number of really important product launches throughout the year. And just to name a few of them, we've got Evolut FX, we've got ECAPs, we've got Diabetic Painful (sic) [Peripheral] Neuropathy. And again, I'm just naming a few. So I hope that's helpful and shows what our guidance implies as we move throughout the year.

第三，我們的年比業績表現更加穩健，尤其是下半年。最後，我們全年發布了一系列非常重要的產品。例如，Evolut FX、ECAPs、糖尿病疼痛性[週邊]神經病變。再次強調，我只是列舉了其中幾個例子。希望以上內容對您有所幫助，並能讓您了解我們的指導方針在全年發展中的意義。

Thanks Vijay. Next question, Brad.

謝謝維傑。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。

I'll ask a 2-part one as well. I guess, first on the elective procedure recovery. Curious how May is shaping up versus April kind of around the world, both in the U.S. and China as well. And then the second part was going back to kind of some of the supply chain issues. The impact this quarter is a little bit worse than some of your peers. I don't know if things got a lot worse in April, or there was something specific with surgical innovations. I just want to make sure we have the confidence that, that's going to start to improve here in the next quarter or 2.

我也會問兩個問題。我想，首先是關於選擇性手術的恢復情況。我很好奇5月與4月相比，全球（包括美國和中國）的情況如何。第二部分是關於一些供應鏈問題。本季的影響比一些同業要嚴重一些。我不知道4月的情況是否變得更糟，還是手術創新有什麼特別的原因。我只是想確保我們有信心，這種情況會在下一季或第二季開始好轉。

Sure. I'll take the second one first. The supply chain issues, yes, they did -- look, they did -- no one's more disappointed about our Q4 miss than I am, and we got -- we believe we understand the root cause of that miss.

當然。我先說第二個。供應鏈問題，是的，確實存在——你看，確實存在——沒有人比我更對我們第四季度業績不及預期感到失望，而且我們相信我們已經了解了業績不及預期的根本原因。

And it really started hitting us in the second half of Q4. And I'd say that 75% of the miss is due to -- of the $340 million, $350 million miss is due to supply chain. 15 -- and I'll get into that in a second, maybe about 15% is due to the China lockdown and then maybe another 10% is FX getting worse, and Karen can talk about that.

第四季下半年，疫情對我們造成了真正的衝擊。我認為，75%的虧損是因為供應鏈問題——3.4億美元和3.5億美元的虧損。 15%——我稍後會講到——大概15%是因為中國疫情封鎖，另外10%可能是外匯市場惡化，Karen可以談談這個問題。

But in the miss, the supply chain miss, it hit us across a number of businesses, but it was definitely the most pronounced in our Surgical Innovations business, and it was 3 things. It was semiconductors, which is affecting everybody, that affected a number of businesses, but particularly in our SI business. It also was resins, a particular resin that we use in our energy business in SI has been a major source of problem for us.

但供應鏈的失誤對我們多個業務造成了衝擊，其中最明顯的無疑是外科創新業務，主要影響了三個面向。首先是影響所有人的半導體業務，它影響了多個業務，尤其是外科創新業務。其次是樹脂，我們在外科創新能源業務中使用的一種特殊樹脂一直是我們面臨的主要問題。

And then packaging, our trade packaging there was a catastrophic explosion in our supply chain. And so those last 2 ones, the packaging and the resins were the biggest issues, the biggest supplier decommits, and I'd say the biggest surprise, and most of that was in SI. We see this getting better over the next -- the SI one is -- overall for the company, we see the supply chain issues getting -- abating over the next quarter or 2. The SI issues probably it will take more than a quarter or so, put it on the first half of the year to get through those issues. We factored all that into our guidance.

然後是包裝，我們的貿易包裝，我們的供應鏈出現了災難性的爆炸性增長。最後兩個問題，包裝和樹脂，是最大的問題，最大的供應商退出了，我想說這是最大的意外，而這大部分都發生在SI（供應鏈管理）上。我們預計這種情況會在接下來的一個季度裡有所改善——就SI而言——總體而言，對於公司而言，我們看到供應鏈問題在接下來的一兩個季度有所緩解。 SI問題可能需要一個多季度的時間才能解決，預計要到上半年才能解決。我們將所有這些因素納入了我們的預期。

I mentioned China. We have -- remember, we have April. This really hit us in April. We have April in our Q4, and that represented roughly about $60 million of the shortfall combination of the COVID lockdown. And Karen mentioned some of the volume-based procurement.

我提到了中國。記住，我們四月的情況。疫情對我們造成了極大的打擊。四月是我們第四季，這大約相當於新冠疫情封鎖措施造成的6000萬美元的缺口。 Karen也提到了一些大量採購。

So other than China, our emerging markets, as Karen mentioned in the commentary, grew 20%. China was actually down 10% or more and the rest of emerging markets grew 20%. And so these -- like I said, these acute issues, I mentioned in the commentary and one of my answers were well down the path of remaking our global ops and supply chain to provide that resiliency that we just haven't had.

因此，除了中國之外，正如卡倫在評論中提到的，我們的新興市場成長了20%。中國實際上下降了10%或更多，而其他新興市場則成長了20%。所以，正如我之前所說，這些我在評論中提到的尖銳問題，以及我的一個回答，都與重塑我們的全球營運和供應鏈，以提供我們目前尚未具備的韌性息息相關。

And we started that over a year ago, centralizing the function and bringing in some -- building a very strong leadership team under Greg, bringing in new people from different industries, investing in all kinds of whether it be tools and technology and operating mechanisms for this.

我們在一年多前就開始了這項工作，集中職能並引入一些人才——在格雷格的領導下建立了一支非常強大的領導團隊，引進了來自不同行業的新人才，投資於各種工具、技術和營運機制。

And I know I'm confident we're going down the right path there. And I'm glad that we started when we did. I wish we would have started even earlier. But -- so the long-term building those fundamentals will take some time. But the acute issues that hit our numbers will go away or get better over the next quarter or 2.

我相信我們正朝著正確的方向前進。我很高興我們當時就啟動了。真希望我們能更早開始。但是，長期建立這些基本面需要一些時間。不過，影響我們業績的那些突出問題將會在未來一兩個季度內消失或改善。

I'll turn it over to Karen to answer the first part of the question.

我將把問題的第一部分交給凱倫來回答。

Yes, Travis, thank you. So just in terms of the month of May, it's still early. And we're obviously focused on managing through some supply issues that we've got in some of our businesses. So the numbers are a little cloudy, but when we look at our operating units that are not impacted by supply issues, just through the first 3 weeks of May, we're trending largely in line with where we were first quarter last year. And I would note that elective procedures for the most part were back to pre-COVID levels for us last quarter.

是的，崔維斯，謝謝你。就五月而言，現在還為時過早。我們顯然正專注於解決部分業務中存在的供應問題。因此，數據可能有些模糊，但就我們未受供應問題影響的營運部門而言，截至五月前三週，我們的趨勢與去年第一季基本一致。我想指出的是，上個季度，我們大部分非急診手術的數量已恢復到新冠疫情之前的水平。

Thanks Travis. Take the next question, Brad.

謝謝特拉維斯。布拉德，請回答下一個問題。

The next question comes from Larry Biegelsen with Wells Fargo Securities.

下一個問題來自富國證券的拉里·比格爾森。

Just Geoff, on the kidney company news today, should we expect more like this? Or could they be more significant? Just kind of remind us of what the overarching goals are. And Bob, maybe on Hugo, just help us understand what the expectations are for fiscal '23, the status of the supply constraints and the preop setup error, and when you expect to start the U.S. pivotal trial.

傑夫，關於今天腎臟公司的新聞，我們應該期待更多類似的消息嗎？或者它們會更重要？只是提醒我們一下整體目標是什麼。鮑勃，關於雨果，請幫助我們了解對23財年的預期，供應限制和術前設置錯誤的現狀，以及您預計何時啟動美國關鍵試驗。

On the Renal Care Solutions joint venture with DaVita, this is what I'd characterize as a smaller initial step in terms of our portfolio management work. That work continues, and we do anticipate that there could be more portfolio moves over the course of FY '22. I'm not going to comment on the size of those. But I'd characterize this is a smaller initial step. It's been under consideration for a while.

關於與 DaVita 成立的 Renal Care Solutions 合資公司，我認為這是我們投資組合管理工作中較小的初始步驟。這項工作仍在繼續，我們預計在 2022 財年可能會有更多投資組合調整。我不會評論這些調整的規模。但我認為這是較小的初始步驟。我們對此已經考慮了一段時間。

And like I said in the commentary, I am excited about this. This technology that we've been working on for years, I think DaVita, this joint venture, will bring more focus to that finishing up the development. And then I think, obviously, DaVita is a leader in kidney care and will be a great partner as we commercialize and scale this innovative technology. They bring a lot to the table there. And I think we bring a lot to the table on the technology side and looking forward to it.

正如我在評論中所說，我對此感到興奮。我們多年來一直在研發這項技術，我認為DaVita這家合資公司將更專注於完成其開發。而且，我認為DaVita顯然是腎臟護理領域的領導者，在我們商業化和推廣這項創新技術的過程中，他們將成為我們優秀的合作夥伴。他們在這方面貢獻良多。我認為我們在科技方面也貢獻良多，我對此充滿期待。

But as we move forward, I don't know that I'm not -- the other portfolio moves would be JVs or anything like that. For this one -- this one just made the most sense. And we think there's a lot of upside in this technology and the way we structured this deal. Both DaVita and Medtronic will share in that upside. So looking forward to that.

但隨著我們繼續前進，我不知道我是否會…其他投資組合的舉措可能是合資企業或類似的。就這一項而言──這才是最合理的。我們認為這項技術以及我們建立這筆交易的方式有很多好處。 DaVita和美敦力都將分享這項好處。所以我們對此充滿期待。

In terms of the goals of the portfolio work, they remain unchanged. Our North Star is durable growth, durable growth without taking a step back on margins and free cash flow. We just want a higher level of growth. And so we want to remake the portfolio for a higher (inaudible) and more consistency and growth.

就投資組合工作的目標而言，這些目標保持不變。我們的北極星是持久增長，在利潤率和自由現金流不受影響的情況下實現持久增長。我們只希望實現更高的成長水準。因此，我們希望重塑投資組合，以實現更高（聽不清楚）且更穩定、更強勁的成長。

So that's the goal. And I think the other -- the secondary goal would be just to simplify the company a bit. So that's -- those are the goals. That's where we're headed and more to come.

這就是我們的目標。我認為另一個——次要的目標就是稍微簡化一下公司。這就是──這些就是我們的目標。這就是我們的目標，未來還會有更多。

Thanks, Geoff. And Larry, good to hear from you. Thanks for the question. Let me provide you a good update on Hugo. So we're still in limited market release. We're making good progress on the supply chain issues. We're currently in 8 countries. We've had a number of installs this past quarter in France and Italy and Denmark. We did receive regulatory approval in Brazil in Saudi Arabia, and you'll recall this followed Canada and Australia.

謝謝，Geoff。 Larry，很高興收到你的來信。謝謝你的提問。我來跟你報告Hugo的最新情況。我們目前仍在有限的市場發布階段。我們在供應鏈問題上取得了良好的進展。目前，我們的產品已覆蓋8個國家。上個季度，我們在法國、義大利和丹麥都有一些安裝。我們確實獲得了巴西和沙烏地阿拉伯的監管批准，你還記得，之前我們獲得了加拿大和澳洲的批准。

We've begun general surgery cases in Panama, in Chile, in India, and now have done procedures across urology, gynecology, and general surgery including our first bariatric case which was a nice milestone.

我們已經開始在巴拿馬、智利和印度進行普通外科手術，現在已經完成了泌尿科、婦科和普通外科手術，包括我們的第一例減肥手術，這是一個很好的里程碑。

The second part of your question was relating to the IDE. We expect to begin the IDE relatively soon. We're working closely to train the site personnel and gain IRB approval. So we'll certainly keep posted on that. But hopefully, that helps on a good thorough update for where we stand on Hugo.

您問題的第二部分與 IDE 有關。我們預計 IDE 很快就會啟動。我們正在密切合作，培訓現場人員並獲得 IRB 的批准。因此，我們一定會持續更新相關資訊。希望以上資訊能幫助我們全面了解 Hugo 的進展。

Thanks Larry. Next question please, Brad.

謝謝拉里。布拉德，請問下一個問題。

The next question comes in Shagun Singh at RBC Capital Markets.

下一個問題來自加拿大皇家銀行資本市場的 Shagun Singh。

I was just wondering if you can give us an update on your portfolio management initiatives. What are you assuming for Hugo sales in your FY '23 guidance? And can you elaborate on the magnitude of China VBP impacted FY '23?

我只是想知道您能否向我們介紹一下您的投資組合管理計劃的最新情況。您在23財年的業績指引中對Hugo的銷售額有何預期？能否詳細說明中國VBP對23財年的影響程度？

And lastly, if you can just comment on the capital environment. We've heard some puts and takes. Q1 has been a little soft. Just what your outlook is for the full year.

最後，能否評論一下資本環境？我們聽到了一些利弊。第一季業績略顯疲軟。您對全年的展望如何？

Okay, all right. We've got some good music there for a second. But I'll start, maybe there was a couple of others on the list there, so maybe Karen can help me out. But I'll start on the Hugo one. We haven't quoted Hugo numbers for FY '23, but I'll just say we expect a strong ramp because the order book is really strong.

好的，好的。我們有一些不錯的音樂。不過我先說說，名單上可能還有其他幾首歌，所以Karen 可以幫我看看。我先從雨果獎開始說。我們還沒有公佈23財年的雨果獎數據，但我只能說，我們預計會強勁成長，因為訂單量真的很強勁。

You heard Bob just give an update about all the countries we've got approvals in and the different type of procedures that we're now doing, various type of procedures, including general surgery procedures. So we're moving up the food chain there. So we really gained a lot of confidence that we have something in Hugo, and we see a nice ramp in FY '23. But we haven't quoted exact numbers.

你剛剛聽到鮑勃介紹了我們已獲得批准的所有國家/地區以及我們目前正在進行的各種類型的手術，包括一般外科手術。所以，我們正在向這些領域的上游發展。因此，我們真的非常有信心，相信Hugo計畫會取得一定進展，並且我們預計23財年會有不錯的成長。但我們還沒有公佈具體數字。

In terms of the capital environment, capital for us in Q4 was a bright spot. And a lot of our capital that we sell are tied, directly tied to specific revenue-producing procedures, profitable procedures. I think that helps. And we had record numbers in the Neuroscience space, in our Spine business. We have record number of sales of our StealthStation Navigation O-arm and Mazor. That capital equipment is at record highs for us.

就資本環境而言，第四季的資本狀況對我們來說是一個亮點。我們出售的許多資本都與特定的創收程序、獲利程序直接相關。我認為這很有幫助。我們在神經科學領域和脊椎業務方面取得了創紀錄的業績。我們的StealthStation導航O型臂和Mazor的銷售量也創下了歷史新高。這些資本設備對我們來說都創下了歷史新高。

And we're really excited as we place those or we sell those -- that capital equipment, that's just further building out our ecosystem, which is our differentiating strength in the Spine business and portrays optimism for the future of that business.

當我們放置或出售這些設備時，我們感到非常興奮——這些資本設備進一步建立了我們的生態系統，這是我們在 Spine 業務中的差異化優勢，並展現了對該業務未來的樂觀態度。

I'll turn it over to Karen for the other parts of the question.

我將把問題的其他部分交給凱倫來回答。

Thanks, Geoff. The other 2, you had a question on portfolio management, which I know Geoff shared when he answered Larry's question. So I'll cover China VBP. With VBP, we've been dealing with a variety of regional and national tenders already.

謝謝，Geoff。另外兩位，你問了一個關於投資組合管理的問題，我知道Geoff在回答Larry的問題時也提到了這個問題。所以我來談談中國VBP。透過VBP，我們已經處理過各種地區和國家的招標項目了。

And just from a national expected we expect the government to continue to focus on the top 10 medical device products by public insurance spending. So we've been through stents already, and some of our other industry players have gone through large joints. And we see 2 more potential tenders on that list where we've got exposure, spine and surgical stapling.

從全國預期來看，我們預期政府將繼續關注公共保險支出排名前十的醫療器材產品。我們已經完成了支架產品的招標，其他一些業內公司也完成了大型關節產品的招標。我們還看到名單上還有兩個潛在的招標項目，分別是暴露、脊椎和外科縫合器。

And I talked about the fact that we expect Spine to impact us this fiscal year and to likely happen in the second quarter. But ahead of tenders, distributors do pull back on their purchases. So we built that into our first quarter guide as well.

我之前提到，我們預計Spine將對本財年產生影響，並且很可能在第二季顯現。但在招標前，分銷商確實會減少採購。所以我們在第一季的業績指引中也提到了這一點。

Just to remind you, though, our gross exposure for both spine and stapling in China is somewhere between 1% to 1.5% of our total company revenue. So it is small. And based on what we experienced with the coronary tender, we do believe there could be offsets to the ultimate net impact number because we have pull-through of other product lines, and we'll be working on those.

不過，要提醒的是，我們在中國脊椎和縫合器業務的總營收占公司總營收的1%到1.5%之間，所以佔比很小。根據我們在冠狀動脈投標中的經驗，我們確實認為最終的淨影響數字可能會有所抵消，因為我們有其他產品線的拉動，我們正在努力應對這些影響。

Thanks Shagun. Let's go to the next question, please Brad.

謝謝Shagun。 Brad，我們進入下一個問題。

The next question comes from Josh Jennings at Cowen & Company.

下一個問題來自 Cowen & Company 的 Josh Jennings。

I wanted to ask on the diabetes U.S. pump business. I know there's a lot of moving parts. But just with the further deceleration in fiscal 4Q, I was hoping you could share some insights in terms of why you think that's occurring. Is the warning letter in place kind of painting endocrine prescription patterns or patient sentiment? Are you seeing incremental renewal pressure? Just wanted to get a better sense and then how you see that U.S. pump business trending over the course of the year.

我想問一下美國糖尿病幫浦業務的情況。我知道這裡面有很多變數。但鑑於第四季度的進一步放緩，我希望您能分享一些見解，解釋一下您認為出現這種情況的原因。這封警告信是在描繪內分泌處方模式還是病人情緒？您是否看到了增量的續約壓力？只是想更了解一下，您如何看待美國泵浦業務在今年的趨勢。

And then any other incremental details you can share just on interactions with the FDA? And I know you pulled that out of your guidance for fiscal '23 any 780G regarding for approvals. But what gives you hope that you could still see those approvals occur in this fiscal year?

您能分享一些關於與FDA互動的其他細節嗎？我知道您從2023財年780G指南中移除了與FDA核准相關的內容。但是，是什麼讓您相信本財年仍能獲得這些批准呢？

All right. Thanks, Josh, for the questions. I'm going to turn it over to Sean here in a second, although he has officially moved on from that role to focus exclusively on our Cardiology portfolio. We have him on the call answering the Diabetes questions this quarter.

好的。謝謝喬希的提問。我馬上就把時間交給肖恩，儘管他已經正式卸任，專注於我們的心臟病學業務。本季我們將請他來回答有關糖尿病的問題。

And I'll just say a few words about Cue Dallara. She joined the company here a couple of weeks ago and has taken over our Diabetes Business Unit, and we couldn't be really excited about having Cue. She's already diving right in, she's already at ATTD, and she'll be in some other upcoming diabetes meetings that you'll get to see her. And she'll be on our next earnings call to field these questions, and she's getting settled in now and is moving her family out to our Northridge, California site and really excited you'll get a chance to hear from her shortly.

我只想簡單介紹一下 Cue Dallara。她幾週前加入公司，接管了我們的糖尿病業務部門，我們非常期待 Cue 的加入。她已經全心投入工作，已經加入 ATTD，還會參加一些即將舉行的糖尿病會議，屆時大家會看到她。她也會參加我們下次的財報電話會議，回答這些問題。她現在正在安頓下來，帶著家人搬到我們位於加州北嶺的工廠，非常期待您很快能有機會與她聯繫。

In the meantime, I'm going to field this question to Sean. So Sean, can you answer the question that Josh posed?

同時，我會把這個問題轉達給肖恩。肖恩，你能回答喬希提出的問題嗎？

Yes, sure, Josh, thanks for the question. So the dynamics on the revenue side of things are really all about the competitiveness in the United States. We grew sequentially quarter-on-quarter in EMEA by 20%, high 20s. And that's really based on the strong demand for that combination of 780 and the Guardian 4 sensor, which is now in 40 different countries.

是的，當然，Josh，謝謝你的提問。所以，營收方面的動態其實完全取決於美國市場的競爭力。我們在歐洲、中東和非洲地區的銷售額環比成長了20%，達到了20%多一點。這實際上是基於對780和Guardian 4感測器組合的強勁需求，目前該組合已覆蓋40個不同的國家。

So everywhere we go, it's really picked up a lot of steam. This past quarter, that was driven by favorable reimbursement. We had no reimbursement in either France or Germany. We picked up that reimbursement and that really helped us drive that continued growth.

所以，無論我們走到哪裡，業務都獲得了巨大的成長。上個季度，這得益於良好的報銷情況。我們在法國和德國都沒有報銷。我們獲得了報銷，這確實幫助我們推動了持續成長。

So within the U.S., the dynamic is obviously people waiting for the new technology to come before prescribing it for new patients or some patients not wanting to wait for it and moving on to competitive therapies.

因此，在美國，情況顯然是人們等待新技術出現後再將其開給新患者，或者一些患者不想等待，而是轉向競爭性療法。

With regard to the warning letter progression, it's really -- as Karen said, we did conservatively lead that out of the guidance, I think that's prudent. But the most important thing we have to do is to improve and sustainably improve the quality system, which was outlined in those items that were in the 43 and the subsequent warning letter.

關於警告信的進展，正如Karen所說，我們確實在指導意見中採取了保守的引導方式，我認為這是謹慎的做法。但我們最重要的事情是改進並持續改進品質體系，這在第43封警告信以及隨後的警告信中都有概述。

And we've made excellent progress against those commitments. We're more than 80% the way through fulfilling all those commitments. And it's also important to note that the 780 and Guardian 4 Sensor are under active review with the FDA right now. And we don't want to get ahead of the FDA on timing or predictions, and that's really the reason for the conservatism, but it'll suffice to say, there's a huge interest from patients. The technology continues to prove itself in real-world applications.

我們在兌現這些承諾方面取得了顯著進展。我們已完成所有承諾的80%以上。同樣值得注意的是，780和Guardian 4感測器目前正在接受FDA的積極審查。我們不想在時間安排或預測上搶在FDA之前，這也是我們持保守態度的原因，但可以肯定的是，患者對此非常感興趣。這項技術正在實際應用中不斷證明其價值。

And you just see the numbers going up for both revenue, as well as the data we shared, the recent ATTD meeting, the coming up ADA. It's really a robust solution, a unique solution, where we're getting kids to time and range that has never been seen before. And that's during the day, overnight.

你會看到，收入和我們分享的數據都在成長，包括最近的ATTD會議和即將舉行的ADA。這確實是一個強大的解決方案，一個獨特的解決方案，我們讓孩子們能夠享受前所未有的時間和範圍。而且，無論是白天或晚上。

And of course, it's worked for adults too at the highest time and range yet reported. So we're very confident that when we get the solution out, we'll turn the boat around. But I think for conservatism because we can't predict it. That's what's in the guidance.

當然，它對成年人也有效，並且達到了迄今為止報告的最高時間和最長範圍。因此，我們非常有信心，一旦找到解決方案，就能扭轉局面。但我認為應該保守一些，因為我們無法預測。這就是指南中的內容。

Thanks Josh. Next question please, Brad.

謝謝喬希。布拉德，請問下一個問題。

The next question comes from Joanne Wuensch at Citi.

下一個問題來自花旗銀行的 Joanne Wuensch。

So when I take a look at your guidance, you've got what, in your words are or is a pretty conservative first quarter, and then it ramps pretty aggressively throughout the remainder of the year. I know you don't like to give quarterly guidance, but just to sort of level set us so that we're not resetting the quarters as we go along, talk us through how you ramp and what improves.

所以，當我看您的業績指引時，我發現，用您的話來說，第一季的業績相當保守，但在今年剩餘時間裡，您的業績會大幅成長。我知道您不喜歡給予季度指引，但為了讓我們保持平衡，避免在發展過程中重新設定季度目標，請談談您是如何成長的，以及有哪些改進。

And if you can just sort of give the classic like X percent in the first quarter, Y in the second quarter, et cetera, that would be really helpful. Just to sort of build out from here.

如果你能給出一些經典的數據，像是第一季的X%，第二季的Y%，等等，那就很有幫助了。這樣就能從這裡開始建置了。

Yes. Thanks, Joanne, for the question. I'm going to not give specific guidance for the other quarters, but I will let you know that we've got these things that anniversary through the quarter. So ventilator sales was up and down in the quarter. And I know Ryan can take you in the after call about those changes that happened in ventilator sales.

是的。謝謝喬安妮的提問。我不會給出其他季度的具體指導，但我可以告訴你，我們在本季度經歷了這些週年紀念日。所以本季呼吸器的銷量有起有落。我知道瑞安可以在後續電話會議中跟你談談呼吸機銷售方面發生的變化。

And then obviously, we expect our biggest supply challenges this quarter and starting to improve in second quarter. So think about a ramp of revenue growth just getting better and better every quarter. And by the time you get to the back half, our year-over-year comps obviously get easier. And particularly in the fourth quarter, particularly in: Med Surg, given the fourth quarter that we had.

顯然，我們預計本季將面臨最大的供應挑戰，但第二季情況將會改善。所以，想像一下，每季的營收成長都會越來越好。到下半年，我們的年比業績顯然會更容易實現。尤其是在第四季度，尤其是在醫療外科領域，考慮到我們第四季度的業績表現。

So think of strongest growth, obviously, in the fourth quarter as you ramp. And that is in line with how we think about our product launches too going through the year. We've got some product launches that are helping us earlier in the year, and then more that will ramp as we go through the year. So I know that Ryan can easily take you through some more of the detail, too.

所以，最強勁的成長勢頭顯然出現在第四季度，因為你們正在加速成長。這也與我們全年產品發布的思路一致。我們今年稍早推出了一些產品，這對我們很有幫助，之後還會有更多產品隨著全年的成長而加速。我知道Ryan也可以輕鬆地向你們詳細介紹一下。

Appreciate that. And then for my second question, Renal Denervation, you've completed the enrollment of the last piece of the puzzle. It sounds like data won't be presented in the fall, but we may get data in the spring. Are you thinking FDA approval mid next year, calendar year?

非常感謝。然後，關於我的第二個問題，腎臟去神經支配療法，您已經完成了最後一塊拼圖的招募工作。聽起來數據不會在秋季公佈，但我們可能會在春季獲得數據。您認為FDA會在明年年中或自然年批准嗎？

Sean, you want to take that one?

肖恩，你想拿那個嗎？

Yes, Joanne, we will file that last piece of the PMA, which is that last bit of data when we have it. And that would dictate the timing for the review clock to start. So it's important to note that we've done a modular PMA. So every other part of this device characterization, all the manufacturing modules has already been reviewed and closed. So it's really this last piece of it that would go into the review.

是的，喬安妮，我們會提交PMA的最後一部分，也就是我們拿到的最後一點數據。這將決定審查開始的時間。所以要注意的是，我們已經完成了模組化PMA。因此，該設備特性描述的其他所有部分，所有製造模組都已經過審查並完成。所以，真正進入審查的是PMA的最後一部分。

Thank you Joanne. We have time for one more question, Brad.

謝謝喬安妮。布拉德，我們還有時間再問一個問題。

Our final question comes from Pito Chickering, Deutsche Bank. Pito, please go ahead. Pito, are you on mute?

最後一個問題來自德意志銀行的Pito Chickering。 Pito，請繼續提問。 Pito，你是不是靜音了？

Yes. Can you guys hear me now?

是的。你們現在聽得到我說話嗎？

Yes. We can.

是的，我們可以。

This question is sort of pretty hard to answer, but I'll ask it anyway. We heard U.S. hospitals are beginning to defer procedures due to lack of contrast dye supplies for Interventional Cardiology. Any chance you can let us know what you're seeing and hearing, what you're assuming is in your first quarter guidance? And what, if any, impact there is from outside the U.S. due to the shortages from GE?

這個問題有點難回答，但我還是想問一下。我們聽說，由於介入性心臟病學造影劑供應不足，美國醫院開始延後手術。您能否告訴我們您的所見所聞？您認為第一季的業績預期是怎麼樣的？通用電氣的短缺對美國以外的地區有何影響？

Yes, thanks, Pito, for that question. So contrast dye we believe it's a transient issue. It's mostly contained to the U.S. It is something that we're closely watching because it can impact our Cardiovascular and Neurosciences' portfolios. But we do expect it to resolve within the quarter just based on what we're hearing.

是的，謝謝Pito的提問。我們認為造影劑問題只是暫時的，主要在美國境內。我們正在密切關注，因為它可能會影響我們心血管和神經科學領域的產品組合。但根據目前的情況，我們預計這個問題將在本季得到解決。

Many health systems in the United States have already instituted conservation measures. And we're working with them to see how we can help support them through thoughtful allocation. But at this stage, we've built our view of it into the guidance for the first quarter, and we do believe it's a transient issue getting better after the first quarter.

美國許多醫療系統已經採取了節約措施。我們正在與他們合作，研究如何透過合理的分配來幫助他們。目前，我們已將對此的看法納入第一季的指導方針中，我們確實認為這只是一個暫時現象，第一季之後會逐漸改善。

A quick follow-up on the transaction with DaVita today. What was the organic growth rate of Renal Care Solutions, and kind of what is the strategic value you guys are seeing adding to your portfolio?

今天快速跟進與 DaVita 的交易。腎臟護理解決方案的有機成長率是多少？你們認為它能為你們的投資組合帶來哪些策略價值？

Well, I'll answer it. Thanks for the question, Pito. I'll answer the second part of it, the strategic value. I mean look, I think we both -- the transaction revolves around a big piece of the value creation will be us bringing in some innovative home dialysis technologies to the market that the inherent in that technology is some something that we picked up from other businesses in Medtronic and the IP around it and the know-how.

好吧，我來回答。謝謝你的提問，Pito。我來回答第二部分，戰略價值。我的意思是，我認為我們雙方——這筆交易的很大一部分價值創造在於我們將一些創新的家庭透析技術推向市場，這些技術本身就是我們從美敦力其他業務部門學到的，以及相關的知識產權和專業知識。

And we're building that into this home dialysis technologies. There will be a couple of different products. It drives up access, it lowers costs and there's a better patient experience. And we bring that to the table. But just even just in the United States context, the dialysis market is pretty unique. And the go-to-market channel is not something that we have any kind of synergies with.

我們正在將其融入家庭透析技術中。將會有幾種不同的產品。這將提高可近性，降低成本，並改善患者體驗。我們正致力於實現這些目標。但即使在美國，透析市場也相當獨特。我們與市場進入通路沒有任何協同效應。

And so DaVita brings one, that channel that access to these customers, and they have a lot of -- obviously, they're a leader in kidney care, so they bring a lot of clinical expertise as well. So I think it really is regarding the home dialysis technology. It is 1 plus 1 definitely equals more than 2 here. And we're excited about it. We think it's going to have a big impact. And the way like I said before, the way we structured it we get to share in the upside with DaVita. In terms of the other question the organic...

DaVita 帶來了一個接觸這些客戶的管道，而且他們擁有很多——顯然，他們是腎臟護理領域的領導者，所以他們也帶來了很多臨床專業知識。所以我認為這真的與居家透析技術有關。在這裡，1 加 1 絕對大於 2。我們對此感到興奮。我們認為它會產生巨大的影響。而且就像我之前說的，我們建構它的方式讓我們能夠與 DaVita 分享收益。至於另一個問題，有機…

It's about the growth in renal care, Pito, and it was low single digits for us last fiscal year. it is a lower growth, lower margin business for us.

皮托，這是關於腎臟護理業務的成長，上個財年我們的成長僅為個位數。對我們來說，這是一個成長較低、利潤率較低的業務。

Thanks, Pito. Geoff, please go ahead with your closing remarks.

謝謝，Pito。 Geoff，請繼續你的結束語。

Sure, thanks, Ryan. Okay. Well, thanks for the questions, everyone. And as usual, we appreciate your support and your continued interest in Medtronic. And look, I realize there's a lot to sort through here, including the macro issues of supply chain in China that surprised us this quarter. But as we've talked about, we've conservatively factored these into our guidance going forward.

當然，謝謝，Ryan。好的。好的，謝謝大家的提問。和往常一樣，我們感謝您的支持以及您對美敦力的持續關注。我知道這裡有很多問題需要解決，包括本季令我們感到驚訝的中國供應鏈宏觀問題。但正如我們之前提到的，我們已經保守地將這些因素納入了未來的業績預期中。

But I think more importantly, I hope you see that there's a clear direction, a clear direction of travel for the company, where we're headed. And it gets back to some of the questions earlier, like Vijay posed in terms of us getting to that mid-single digit, that 5% plus and the double-digit shareholder returns on a consistent basis.

但我認為更重要的是，我希望你們看到公司有一個明確的方向，一個明確的前進方向，一個我們前進的方向。這又回到了先前提到的一些問題，例如維傑提出的，我們能否持續實現中等個位數、5%以上以及兩位數的股東回報率。

The things that we're doing, the new operating model that's driving the more innovation-driven growth, the capital allocation and portfolio management to reposition our portfolio for higher growth. And finally, the global operations and supply chain changes that we were working on to provide that resiliency and provide that consistency that we need -- these are the right things to do.

我們目前正在做的事情，包括推動創新驅動型成長的新營運模式、重新定位投資組合以實現更高成長的資本配置和投資組合管理。最後，我們正在努力實現全球營運和供應鏈變革，以提供我們所需的彈性和一致性——這些都是正確的做法。

I'm confident -- I mean the macro environment has made it choppier to execute on these things, but we're heading in the right direction. We're making the right moves. And just again, this will -- this will benefit the company and get us where we need to go.

我有信心——我的意思是，宏觀環境使得這些事情的執行更加艱難，但我們正朝著正確的方向前進。我們正在採取正確的行動。而且，這將會——這將使公司受益，並帶領我們走向我們需要的方向。

So we're looking forward to update you on the progress in our Q1 earnings program, which we anticipate owning on August 23. And so with that, thanks again for tuning in today, and please stay healthy and safe, and have a great rest of your day.

因此，我們期待向您通報我們第一季收益計畫的進展情況，我們預計將於 8 月 23 日公佈該計劃。因此，再次感謝您今天的收看，請保持健康和安全，並祝您今天過得愉快。