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Goodwill and Intangible Assets
6 Months Ended
Jun. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Intangible Assets

6.   Goodwill and Intangible Assets. The change in the carrying amount of goodwill for the six-month period ended June 30, 2024 is detailed as follows (in thousands):

    

2024

Goodwill balance at January 1

$

382,240

Effect of foreign exchange

 

(807)

Goodwill balance at June 30

$

381,433

Total accumulated goodwill impairment losses aggregated to $8.3 million as of June 30, 2024 and December 31, 2023, respectively. We did not have any goodwill impairments for the six-month periods ended June 30, 2024 or 2023. The total goodwill balances as of June 30, 2024 and December 31, 2023 were related to our cardiovascular segment.

Other intangible assets at June 30, 2024 and December 31, 2023 consisted of the following (in thousands):

June 30, 2024

Gross Carrying

Accumulated

Net Carrying

    

Amount

    

Amortization

    

Amount

Patents

$

30,163

$

(11,876)

$

18,287

Distribution agreements

 

3,250

 

(2,956)

 

294

License agreements

 

11,094

 

(8,759)

 

2,335

Trademarks

 

35,123

 

(22,343)

 

12,780

Customer lists

 

40,225

 

(34,694)

 

5,531

Total

$

119,855

$

(80,628)

$

39,227

December 31, 2023

Gross Carrying

Accumulated

Net Carrying

    

Amount

    

Amortization

    

Amount

Patents

$

28,877

$

(10,916)

$

17,961

Distribution agreements

 

3,250

 

(2,919)

 

331

License agreements

 

11,142

 

(8,327)

 

2,815

Trademarks

 

35,135

 

(20,804)

 

14,331

Customer lists

 

40,367

 

(33,921)

 

6,446

Total

$

118,771

$

(76,887)

$

41,884

Aggregate amortization expense for the three and six-month periods ended June 30, 2024 was $14.8 million and $29.4 million, respectively. Aggregate amortization expense for the three and six-month periods ended June 30, 2023 was $13.4 million and $25.7 million, respectively.

We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows is largely independent of the cash flows of other assets and liabilities. We determine the fair value of our amortizing assets based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. We did not identify indicators of impairment for our intangible assets based on our consideration of triggering events for the six-month periods ended June 30, 2024 and 2023, respectively.

Estimated amortization expense for developed technology and other intangible assets for the next five years consisted of the following as of June 30, 2024 (in thousands):

    

Estimated Amortization Expense

Remaining 2024

$

31,367

2025

 

60,826

2026

 

49,776

2027

46,440

2028

 

45,024