Seeking Alpha: Can Sunshine Heart Survive To See The Dawn?

The market has turned very hostile toward high-risk small-cap med-tech companies, and Sunshine Heart (NASDAQ:SSH) has long struggled to deliver the sort of progress that would make it easy to argue that the market is being unfair. Although the company has resolved a clinical hold, enrollment rates have been an ongoing long-term disappointment and the company's targets for reimbursed procedures have proven much too optimistic. With that, that company's prospects for finishing its pivotal COUNTER HF trial, let alone advancing a better, fully implantable, version of its technology without exceptionally dilutive/expensive financing has basically vanished.

The company's C-Pulse device does seem to provide benefits and quality of life improvements to the majority of patients who get it, but the ongoing issues with site and patient enrollment would seem to speak to more significant problems at the management and strategic level. At this point, these shares look more like a lottery ticket - there are paths by which these shares could succeed from here (including both buyout and go-it-alone strategies), but between the financing and operational issues, it's also quite possible that further losses are in store for shareholders.

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Can Sunshine Heart Survive To See The Dawn?

Seeking Alpha: AtriCure Has Earned Its Multiple

It's hardly a household name, but AtriCure (NASDAQ:ATRC) is a good example of how success rarely goes unrewarded by the Street for too long. The company has done a good job of driving utilization of its surgical ablation tools, and is still ramping up its left atrial appendage exclusion device. As surgeons become increasingly familiar with the procedures, cardiologists, electrophysiologists, and surgeons increasingly coordinate their continuum of care and overall recognition of the danger of untreated/under-treated atrial fibrillation grows, I expect AtriCure to log many years of double-digit growth. Add in the potential of minimally invasive procedures, and I believe this is a company looking at $125 million or so in revenue this year and $2 billion in addressable revenue less than a decade from now.

Companies rarely capture 100% of their available market, and I expect the same from AtriCure. That said, this is a company that has shown that it can drive adoption of its products without the help of a large sales infrastructure, and I still believe a larger medical technology company could look at this as a low-risk/high-return M&A candidate. As the stock is trading about midway between its standalone value and its M&A value (with possible upside from a motivated buyer), I don't see it as a terrific bargain, but it does likely still have some upside from here.

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AtriCure Has Earned Its Multiple

Seeking Alpha: Clouds Still Mar Sunshine Heart's Outlook

Development-stage med-tech Sunshine Heart (NASDAQ:SSH) has had a good run up from its mid-December lows, and the company continues to move forward with the clinical development of a device-based approach for congestive heart failure that could mark a real improvement in quality of care. That said, the company continues to see frustratingly slow enrollment and pushback on reimbursement.

Unfortunately, there don't appear to be easy solutions to Sunshine Heart's primary problem - it lacks the resources of major cardiology companies like Boston Scientific (NYSE:BSX), Medtronic (NYSE:MDT), or St. Jude Medical (NYSE:STJ) that could otherwise support and encourage enrollment. Getting the FDA's permission to run an interim analysis would certainly help, and the shares do appear undervalued, but the company is climbing a steep hill and investors shouldn't kid themselves into thinking that the need for a better treatment for heart failure and the apparent efficacy of Sunshine's C-Pulse system will, on their own, ensure a successful outcome.

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Clouds Still Mar Sunshine Heart's Outlook

Seeking Alpha: Philips Looks To Long-Time Laggard Volcano To Perk Up Its Healthcare Biz

It took a long time, but Volcano (NASDAQ:VOLC) finally found its buyer. Now the question is whether Philips (NYSE:PHG) can generate the growth and profits from Volcano's platform of technologies in intravascular imaging and therapeutics that Volcano's management never could. Investing more resources into image-guided therapeutics is not a bad call on the surface, but Philips must prove that it has moved past its legacy of below-average (if not outright poor) deal integration and must prove that the potential synergies between these two cath lab companies can win out over competitive threats from the likes of Boston Scientific (NYSE:BSX) and St. Jude Medical (NYSE:STJ).

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Philips Looks To Long-Time Laggard Volcano To Perk Up Its Healthcare Biz

The Motley Fool: Boston Scientific Stock Down Slightly on Earnings

All told, Boston Scientific (NYSE: BSX  )  did alright in the second quarter, but the inter-segment noise highlights one of the ongoing challenges for the company – keeping all the ducks in a row and delivering both top-line growth and margin improvement. I'm still skeptical that these shares really make sense from a long-term cash flow perspective, but I cannot argue that the company has not made progress and could generate significant earnings growth in the coming years.

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Boston Scientific Stock Down Slightly on Earnings

The Motley Fool: The Truth Behind Obamacare's Job-Killing Tax

Calling the implementation of the Affordable Care Act (better known as "Obamacare") controversial would be a gross understatement, but the actual effects on the med-tech space are arguably less controversial at this point. Healthcare utilization has not picked up significantly and multiple companies have reported minimal recoveries in procedure/product volumes. What's more, while there has been a wave of M&A in the sector, it has been more about leveraging costs and establishing strong positions as hospitals become increasingly aggressive.

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The Truth Behind Obamacare's Job-Killing Tax

The Motley Fool: Is Medtronic a Buy? What Analyst Day Revealed

Medtronic's (NYSE: MDT  ) June 6 analyst day was by no means light fare, as the company crammed quite a bit of information into more than seven hours. While action-oriented investors are likely disappointed that management's commentary would seem to suggest a bid for Smith & Nephew (NYSE: SNN  ) is not too likely, management laid out a vision of an evolving global device market where Medtronic is likely to be among the few players with the scale to really cover all of the major bases. While Medtronic shares do not appear priced for supreme near-term market outperformance, they still make sense within a diversified portfolio that tends toward the conservative.

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Is Medtronic a Buy? What Analyst Day Revealed

The Motley Fool: Are Boston Scientific Corporation's Little Misses Pilling Up?

Never estimate how often sell-side analysts or institutional investors can shrug off disappointments from stocks they want to like, but it looks like Boston Scientific (NYSE: BSX  ) is starting to chew up some of the goodwill on the Street. Boston Scientific isn't performing poorly per se, but the company continues to report slightly disappointing quarters that run counter to the idea that it has truly turned a corner in its operating history. Boston Scientific shares don't look expensive in a world lacking cheap med-tech names, but it's worth remembering that the Street is already banking on some pretty aggressive margin improvements and sales growth driven by devices yet to even secure approval.

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Are Boston Scientific Corporation's Little Misses Pilling Up?

The Motley Fool: Medtronic's Surprising Update Spikes Blood Pressures Across Med-Tech

A funny thing happened on the way to Medtronic's (NYSE: MDT  ) presumed domination of the emerging $3 billion-a-year renal denervation (RDN) market. RDN might not work ... or at least not nearly as well as initially thought.

While the potential loss of a chunk of that $3 billion pie is not a model-breaker for Medtronic, St. Jude Medical (NYSE: STJ  ) , Boston Scientific (NYSE: BSX  ) , or Covidien (NYSE: COV  ) , it is a good reminder that pilot studies and European approval don't always tell the whole story.

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Medtronic's Surprising Update Spikes Blood Pressures Across Med-Tech

The Motley Fool: New Ideas Offer Hope for Both Heart Failure Patients and Investors

Steep valuations and uncertainty about adoption have created a lot of volatility in the shares of HeartWare International (NASDAQ: HTWR  ) and Thoratec (NASDAQ: THOR  ) , the leading developers of ventricular assist devices or VADs that help seriously ill heart failure patients live longer, better lives. While these companies serve a patient population that is desperately in need of better therapy and can support over $1 billion in revenue, there has always been a bigger market in less seriously ill heart failure patients. Sunshine Heart (NASDAQ: SSH  ) has advanced a very interesting approach for these patients into a pivotal U.S. study, while HeartWare has just recently acquired its own pathway into what could be a multibillion dollar opportunity.

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New Ideas Offer Hope for Both Heart Failure Patients and Investors

Seeking Alpha: Can A More Realistic Volcano Perform Better?

Following Volcano (VOLC) has been a frustrating exercise for many years. Despite strong clinical data supporting the company's core IVUS and FFR platforms, the company has struggled to live up to its own growth expectations and management has stubbornly thrown good money after bad with M&A and R&D spending on projects with unclear (at best) paths to management's growth expectations.

Maybe this is the turn. Missing top-line expectations for the sixth time in seven quarters isn't exactly good news, and neither is the present state of stent procedure volume. On the other hand, abandoning the OCT, FL-ICE, FL-IVUS boosts the probability that management is now looking at its real business prospects in a more rational way and may become more disciplined with its spending priorities. Unfortunately, while I do not ignore the possibility that Volcano could still attract a bid, I don't see a lot of internal value in these shares.

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Can A More Realistic Volcano Perform Better?

Investopedia: Medtronic Marking Time

These aren't the glory days for med-tech giant Medtronic (NYSE:MDT), as fiscal 2014 will be a pretty weak year from a growth perspective ahead of some significant new product launches in 2015. Even with a high-quality name like Medtronic, that lack of growth can lead to shares languishing as investors are attracted to (or distracted by) more impressive-looking stories in the short term. Although I'm not a passionate bull on Medtronic shares by any stretch, the stock is pretty much what passes for a bargain these days in the larger segment of this industry and I think it's a respectable core holding.

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Seeking Alpha: AtriCure's Frustratingly Slow Build Hides Value Beneath

Many investors like to believe that all a med-tech company has to do is develop a product for an under-served market, secure FDA approval, and then sit back and count the money as it rolls in. If only it were so easy. Marketing is often overlooked as a primary challenge, as new therapies often require doctors to change their routines and practices and may threaten older, profitable ways of doing business.

That seems particularly relevant in the case of AtriCure (ATRC). While AtriCure has a good suite of products to treat atrial fibrillation, uptake has been slow and the company is still below the $100 million barrier in annual revenue. Although it's going to take time and patience for this company/stock to work on its own, the market opportunity is real and investors shouldn't ignore the potential that AtriCure attracts a bid from a larger med-tech player.

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AtriCure's Frustratingly Slow Build Hides Value Beneath

Seeking Alpha: A Greater Focus On Outcomes Could Be Explosive For Volcano

It's difficult to call a stock with an EV/EBITDA ratio in the 20's and more than a dozen active sell-side analysts "undiscovered", but I'm surprised at the relative level of chatter about Volcano (VOLC) in comparison to names like Intuitive Surgical (ISRG), MAKO Surgical (MAKO), or Abiomed (ABMD). While Volcano arguably suffers from the fact that its addressed markets have been around quite a bit longer, I believe growth-oriented investors ought to take another look at some of the possibilities of Volcano finding a new level of market acceptance and growth in the coming years.

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A Greater Focus On Outcomes Could Be Explosive For Volcano

Investopedia: The Week In Healthcare

The last week of August proved to be a relatively significant one for multiple med-tech companies. Although the Labor Day holiday is likely to keep a lid on the news flow in the first week of September, there are a few upcoming earnings reports. What's more, the timing of restructurings, acquisitions and the like are inherently unpredictable and I would not be surprised to hear more news along these lines.

Helicos Looks Like It's Out of Moves
Few readers are going to be familiar with Helicos BioSciences (OTC:HLCS), as this tiny life sciences company has failed to successfully commercialize its direct DNA and RNA molecule sequencing technology. Although the technology is legitimately interesting, the company's execution mistakes left it with basically a long-shot survival strategy - suing other, larger, life science companies like Pacific Biosciences (Nasdaq:PACB), Life Technologies (Nasdaq:LIFE) and Illumina (Nasdaq:ILMN) for patent infringement.

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Seeking Alpha: Even After A Big Pullback, Edwards Lifesciences May Still Be Expensive

Edwards Lifesciences (EW) has done a lot of good things - foremost among them being the decision to move beyond its stable, unexciting legacy businesses into more dynamic and more profitable markets. It's a model that St. Jude Medical (STJ) has used to good effect, and it has certainly made this a much more interesting company over the past three years.

The problem, though, is whether or not investors have gotten a little too excited about Edwards Lifesciences and its transcatheter heart valve products. While transcatheter aortic valve implantation (TAVI) is a legitimate breakthrough in medical technology and likely to be a multi-billion dollar market, investors seem to have overshot the mark. Even as Edwards stock has come off about 20% from its highs, current valuation still presupposes a huge level of market transformation.

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Even After A Big Pullback, Edwards Lifesciences May Still Be Expensive