Segment Reporting and Foreign Operations - Operating Income (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Segment Reporting Information [Line Items]
Revenues	$ 120,016	$ 115,210	$ 109,875	$ 103,948	$ 102,231	$ 95,907	$ 100,532	$ 95,618	$ 449,049	$ 394,288	$ 359,449
Operating expenses									166,523	152,351	132,278
Impairment of goodwill									8,089
Operating income (loss)									27,844	29,641	33,190
Total other expense - net									(8,005)	(2,023)	(315)
Income tax expense	1,642	833	1,253	(459)	1,209	1,811	2,719	2,169	3,269	7,908	9,831
NET INCOME									16,570	19,710	23,044
Cardiovascular Segment
Segment Reporting Information [Line Items]
Revenues									432,124	378,493	347,430
Operating expenses									157,479	142,089	122,600
Operating income (loss)									26,597	30,411	38,010
Endoscopy Segment
Segment Reporting Information [Line Items]
Revenues									16,925	15,795	12,019
Operating expenses									9,044	10,262	9,678
Operating income (loss)									$ 1,247	$ (770)	$ (4,820)