Circulatory Support Devices Market Segments - by Product Type (Ventricular Assist Devices, Intra-Aortic Balloon Pumps, Extracorporeal Membrane Oxygenation Systems, Total Artificial Heart, and Others), Application (Hospitals, Ambulatory Surgical Centers, Cardiology Centers, and Others), Distribution Channel (Direct Sales, Distributor Sales), End-User (Hospitals, Specialty Clinics, Ambulatory Surgical Centers), and Region (North America, Europe, Asia Pacific, Latin America, Middle East & Africa) - Global Industry Analysis, Growth, Share, Size, Trends, and Forecast 2025-2035

Circulatory Support Devices Sales

Circulatory Support Devices Market Segments - by Product Type (Ventricular Assist Devices, Intra-Aortic Balloon Pumps, Extracorporeal Membrane Oxygenation Systems, Total Artificial Heart, and Others), Application (Hospitals, Ambulatory Surgical Centers, Cardiology Centers, and Others), Distribution Channel (Direct Sales, Distributor Sales), End-User (Hospitals, Specialty Clinics, Ambulatory Surgical Centers), and Region (North America, Europe, Asia Pacific, Latin America, Middle East & Africa) - Global Industry Analysis, Growth, Share, Size, Trends, and Forecast 2025-2035

Circulatory Support Devices Sales Market Outlook

The global circulatory support devices market is poised to reach approximately $6.5 billion by 2035, growing at a CAGR of around 8.5% during the forecast period from 2025 to 2035. This growth is driven by the increasing prevalence of cardiovascular diseases, advancements in technology related to medical devices, and heightened awareness regarding the importance of early diagnosis and treatment options for heart-related ailments. Moreover, there is a burgeoning demand for minimally invasive surgical techniques, which often necessitate the use of circulatory support devices to ensure patient safety and improved recovery outcomes. The rise in the geriatric population, who are more susceptible to heart diseases, further compounds this growth, combined with the growing number of healthcare facilities equipped to provide advanced cardiac care. Coupled with the progress in healthcare infrastructure and patient-centric approaches, the circulatory support devices market is on a robust growth trajectory.

Growth Factor of the Market

One of the primary growth factors for the circulatory support devices market is the increase in the incidence of heart-related disorders such as coronary artery disease, heart failure, and arrhythmias, which necessitate the use of these devices. Modern technologies have paved the way for innovations in circulatory support, including device miniaturization, enhanced biocompatibility, and improved patient outcomes. The rise in healthcare expenditure globally, particularly in emerging markets, is another significant factor contributing to market growth. Additionally, the growing trend of outpatient and minimally invasive procedures is driving the demand for efficient circulatory support solutions, as patients seek quicker recovery times and reduced hospital stays. Collaborative efforts between healthcare providers and device manufacturers to develop and implement advanced circulatory systems are also propelling market expansion. Furthermore, the increasing number of clinical trials aimed at improving device efficacy and patient safety is likely to yield newer products that will cater to the evolving needs of healthcare.

Key Highlights of the Market
  • Significant growth projected in the circulatory support devices market, reaching approximately $6.5 billion by 2035.
  • Growing prevalence of cardiovascular diseases driving demand for advanced medical devices.
  • Enhanced healthcare expenditure in emerging markets facilitating market growth.
  • Technological advancements leading to innovative product development in circulatory support.
  • Increased focus on outpatient care and minimally invasive procedures.

By Product Type

Ventricular Assist Devices:

Ventricular Assist Devices (VADs) are designed to support heart function, particularly in patients with severe heart failure. This product type is witnessing substantial growth due to the increasing incidence of heart failure and the growing acceptance of VADs as a bridge to heart transplantation. These devices help in improving myocardial perfusion and reducing the workload on the heart, which is crucial for patients awaiting transplant. The advancements in VAD technology, such as smaller sizes and wireless systems, are enhancing patient comfort and mobility. Additionally, the growing awareness among both healthcare professionals and patients about the benefits of VADs contributes significantly to their market demand.

Intra-Aortic Balloon Pumps:

Intra-Aortic Balloon Pumps (IABPs) are used to increase coronary blood flow and reduce the workload on the heart. This type of circulatory support device is essential in critical care settings, especially during cardiac surgeries or acute myocardial infarctions. The rising number of surgical procedures and the increasing prevalence of coronary artery disease are instrumental in the expansion of the IABP market. With continuous improvements in technology, such as automated systems that enhance efficiency and ease of use, IABPs are becoming more common in both emergency and elective care scenarios. Furthermore, physicians increasingly recognize the importance of IABPs for managing high-risk patients, resulting in increased adoption rates in hospitals.

Extracorporeal Membrane Oxygenation Systems:

Extracorporeal Membrane Oxygenation (ECMO) Systems are critical in providing prolonged cardiac and respiratory support to patients whose heart and lungs are severely compromised. The demand for ECMO systems is rising, primarily due to their applicability in treating severe respiratory failure, particularly during pandemics such as COVID-19. As healthcare institutions continue to develop specialized ECMO programs, the market for these devices is expanding. The advancement in ECMO technology, including easier setup and portability, is enhancing their use in various clinical settings, including pediatric care and adult cardiac surgeries. Continuous innovations in ECMO systems further drive their acceptance among healthcare professionals, leading to market growth.

Total Artificial Heart:

The Total Artificial Heart (TAH) represents a revolutionary technology designed to replace the function of a failing heart completely. This product type is particularly beneficial for patients who are not candidates for heart transplantation or are waiting for a donor heart. The growing awareness of TAH as a viable option for end-stage heart failure patients is boosting its market presence. Significant advancements in TAH technology, leading to enhanced performance and biocompatibility, are encouraging its adoption. Furthermore, clinical success stories and ongoing research to improve artificial heart systems are pivotal in fostering a positive outlook for the TAH market.

Others:

This category encompasses other circulatory support devices that may not fit the primary classifications but are essential in specific clinical contexts. Devices such as percutaneous ventricular assist devices and left atrial appendage occlusion devices are gaining traction, driven by their applications in various cardiac procedures. Ongoing innovation and research are likely to introduce new devices in this segment, broadening treatment options for patients with different cardiovascular conditions. Moreover, as technological advancements continue to emerge, these other circulatory support devices are expected to witness increased utilization, contributing positively to the overall market growth.

By Application

Hospitals:

Hospitals are the predominant application segment for circulatory support devices, as they house a range of cardiac care facilities equipped to handle severe cases of heart failure and other cardiac conditions. The availability of specialized cardiac units and monitoring systems in hospitals allows for a higher adoption rate of advanced circulatory support devices. Furthermore, the increasing incidence of heart-related conditions necessitates comprehensive treatment options within hospital settings, leading to the continuous demand for these devices. The shift towards integrated healthcare systems also promotes the use of circulatory support devices, as hospitals strive to improve patient outcomes through advanced technologies.

Ambulatory Surgical Centers:

Ambulatory Surgical Centers (ASCs) are witnessing a growing demand for circulatory support devices as the trend towards outpatient care increases. These centers provide a cost-effective alternative for patients requiring specific procedures without the need for extended hospital stays. The adoption of circulatory support devices within ASCs enhances the ability to manage complex cases, allowing for improved patient safety and efficiency during surgeries. Additionally, the growth of minimally invasive procedures in ASCs is driving a higher need for advanced circulatory support solutions, prompting these facilities to invest in modern devices that can facilitate such interventions.

Cardiology Centers:

Cardiology Centers are specialized facilities focusing on the diagnosis and treatment of cardiovascular diseases, making them a key application area for circulatory support devices. These centers are equipped with advanced technologies and expertise to handle complex cardiac cases, leading to a higher utilization of devices such as VADs and IABPs. The increasing prevalence of cardiovascular ailments propels the demand for circulatory support systems within cardiology centers, as they seek to provide comprehensive care to patients. Furthermore, cardiology centers are at the forefront of clinical research and trials for new device technologies, further enhancing their role in the circulatory support devices market.

Others:

The 'Others' category includes various settings where circulatory support devices may be utilized, such as specialty clinics and home healthcare environments. The growing trend of home healthcare services is significantly influencing this segment, as patients increasingly seek treatment options outside traditional hospital settings. The development of portable circulatory support devices enables patients with chronic heart conditions to manage their health effectively at home. Additionally, specialty clinics focusing on specific cardiovascular treatments are also incorporating circulatory support devices to enhance their service offerings, thereby contributing to market growth.

By Distribution Channel

Direct Sales:

Direct sales are a crucial distribution channel for circulatory support devices, as manufacturers often engage directly with healthcare providers to offer tailored products and services. This approach allows manufacturers to provide comprehensive training and support to medical staff, maximizing the effectiveness of the devices. Direct sales also facilitate better communication regarding product specifications, advancements, and updates, ensuring that healthcare providers are well-informed about the options available. The personalized service model inherent in direct sales pipelines enhances customer satisfaction and loyalty, driving repeat business and further solidifying the presence of circulatory support devices in healthcare facilities.

Distributor Sales:

Distributor sales play a significant role in expanding the reach of circulatory support devices across various medical facilities. Distributors often have established relationships with healthcare providers, enabling them to penetrate diverse markets effectively. This channel is particularly advantageous for smaller manufacturers who may lack the resources to manage a direct sales force. Additionally, distributors can provide valuable insights into market trends and customer preferences, helping manufacturers adjust their strategies accordingly. The utilization of distributor networks facilitates the availability of circulatory support devices in rural and underserved regions, contributing to increased access and adoption of these critical technologies.

By User

Hospitals:

Hospitals remain the primary user of circulatory support devices due to their extensive infrastructure and specialized cardiac care units. The diverse range of patients requiring immediate cardiac support ensures that hospitals are at the forefront of adopting these advanced technologies. With the ongoing trend towards enhanced patient care and outcomes, hospitals invest significantly in the latest circulatory support devices to manage severe cases effectively. The availability of trained personnel and advanced monitoring systems in hospitals ensures that these devices are utilized efficiently, contributing positively to patient recovery and overall health outcomes.

Specialty Clinics:

Specialty clinics focusing on cardiac care are increasingly utilizing circulatory support devices to enhance their treatment offerings. These clinics cater to patients with specific cardiovascular conditions, allowing for targeted and specialized care. The adoption of circulatory support devices in specialty clinics facilitates the management of complex cases that may not require full hospital admission. As the demand for personalized and expert healthcare continues to rise, specialty clinics are likely to expand their use of circulatory support technologies to provide optimal care for their patients, further driving market growth.

Ambulatory Surgical Centers:

Ambulatory Surgical Centers (ASCs) are emerging as significant users of circulatory support devices, particularly as they become equipped to handle a wider range of surgical procedures. The ability to provide effective circulatory support during minimally invasive surgeries is propelling the demand for these devices in ASCs. The trend towards outpatient procedures is leading ASCs to invest in advanced technologies that ensure patient safety and improve recovery outcomes. Furthermore, as ASCs strive to offer comprehensive care, the incorporation of circulatory support devices will likely continue to expand, enhancing the treatment options available in these facilities.

By Region

North America is currently the leading region in the circulatory support devices market, holding a significant share due to advanced healthcare infrastructure, high healthcare expenditure, and a growing prevalence of cardiovascular diseases. The United States, in particular, is a key market player, accounting for a substantial portion of the global sales. The presence of leading medical device manufacturers and continuous innovations in circulatory support technology further bolster the region's position. The North American circulatory support devices market is projected to grow at a CAGR of 9% through 2035, driven by technological advancements and increasing awareness among healthcare professionals regarding the availability of these devices.

Europe follows closely, being another substantial market for circulatory support devices, supported by an aging population and rising healthcare spending across various countries. The European market is witnessing an increase in the utilization of advanced circulatory devices as hospitals and clinics prioritize patient-centric treatment options. The growing focus on improving healthcare outcomes through innovative technologies is likely to further propel the market in this region. Additionally, collaborations between healthcare providers and manufacturers in Europe are promoting the development of new and improved circulatory support devices. Countries like Germany, France, and the UK are particularly significant contributors to the growth of this market within Europe.

Opportunities

The circulatory support devices market presents numerous opportunities for growth, particularly through technological advancements and innovation in product development. As healthcare systems continue to evolve, there is an increasing demand for devices that can be integrated with telemedicine and remote monitoring technologies. This trend is particularly pertinent in the wake of the COVID-19 pandemic, which has accelerated the adoption of remote healthcare solutions. Manufacturers can leverage this opportunity by developing circulatory support devices that incorporate digital health technologies, enabling healthcare providers to monitor patients' conditions in real time, thus improving outcomes and ensuring timely interventions. Furthermore, the rise of personalized medicine opens avenues for developing circulatory support devices tailored to meet the specific needs of individual patients, enhancing the overall treatment experience.

Another significant opportunity lies in the growing market for home healthcare services. With an increasing number of patients seeking treatment at home for chronic cardiovascular conditions, there is a pressing need for portable and user-friendly circulatory support devices. Manufacturers can capitalize on this trend by designing devices that cater to home environments, ensuring ease of use for patients and their families. Additionally, with the prevalence of cardiovascular diseases on the rise globally, particularly in developing countries, manufacturers can explore untapped markets where access to advanced circulatory support devices is limited. By strategically positioning themselves in emerging markets, companies can contribute to improving healthcare outcomes while simultaneously expanding their customer base.

Threats

Despite the promising outlook for the circulatory support devices market, several threats could hinder its growth. One of the primary challenges is the stringent regulatory environment surrounding medical devices. Manufacturers must navigate complex approval processes and comply with rigorous safety and efficacy standards, which can delay product launches and increase operational costs. Additionally, the market faces intense competition from both established players and new entrants, which can lead to price wars and reduced profit margins. This competitive landscape may compel manufacturers to invest heavily in research and development to differentiate their products, putting additional financial strain on smaller companies. Moreover, concerns regarding device-related complications and the need for proper training of healthcare staff in device usage pose significant challenges to widespread adoption.

Furthermore, the economic uncertainties resulting from global events, such as the pandemic, can impact healthcare budgets and spending priorities. As healthcare systems focus on essential services, the allocation of funds for advanced circulatory support devices may be deprioritized, leading to slow market growth. The potential for market saturation in developed regions, coupled with the slow adoption of new technologies in some areas, also presents a threat to manufacturers. To mitigate these challenges, companies will need to adopt agile strategies, focusing on innovation, effective marketing, and the establishment of strong partnerships with healthcare providers to ensure continued relevance in the dynamic landscape of circulatory support devices.

Competitor Outlook

  • Medtronic
  • Abbott Laboratories
  • Boston Scientific Corporation
  • Terumo Corporation
  • Getinge AB
  • CardiacAssist, Inc.
  • ReliantHeart, Inc.
  • SynCardia Systems, LLC
  • MicroPort Scientific Corporation
  • Nipro Corporation
  • Abiomed, Inc.
  • Jiangsu Jisheng Medical Technology Co., Ltd.
  • Thoratec Corporation
  • Edwards Lifesciences Corporation
  • LivaNova PLC

The competitive landscape of the circulatory support devices market is characterized by a mix of established players and emerging companies striving for market share through innovation and technological advancement. Medtronic, one of the leading companies in this sector, offers a diverse range of circulatory support devices, including ventricular assist devices and intra-aortic balloon pumps. Medtronic's commitment to research and development, coupled with its robust distribution network, allows it to maintain a strong presence in the market. Similarly, Abbott Laboratories has made significant strides in the circulatory support space, particularly with its HeartMate line of devices designed to assist patients with advanced heart failure.

Boston Scientific Corporation is another key player in the circulatory support devices market, known for its focus on innovation and product diversity. The company has introduced various technologies aimed at enhancing cardiac care, including devices that support minimally invasive procedures. Getinge AB and Terumo Corporation also occupy significant market positions, focusing on developing advanced ECMO systems and other circulatory support technologies tailored to meet the evolving needs of healthcare providers and patients. The competitive strategies employed by these companies often involve strategic partnerships, collaborations, and mergers and acquisitions to expand their product offerings and reach wider markets.

Emerging companies such as ReliantHeart, Inc. and SynCardia Systems, LLC are also gaining traction by specializing in niche areas of circulatory support, offering advanced solutions tailored for specific patient needs. Their focus on innovation and patient-centric designs enables them to differentiate themselves within a competitive landscape. Furthermore, the entrance of international players like Jiangsu Jisheng Medical Technology Co., Ltd. and MicroPort Scientific Corporation into the market highlights the growing global competition, pushing existing companies to enhance their offerings continually. This competitive dynamic ensures that advancements in circulatory support devices continue to evolve, ultimately benefiting patients and healthcare providers alike.

  • 1 Appendix
    • 1.1 List of Tables
    • 1.2 List of Figures
  • 2 Introduction
    • 2.1 Market Definition
    • 2.2 Scope of the Report
    • 2.3 Study Assumptions
    • 2.4 Base Currency & Forecast Periods
  • 3 Market Dynamics
    • 3.1 Market Growth Factors
    • 3.2 Economic & Global Events
    • 3.3 Innovation Trends
    • 3.4 Supply Chain Analysis
  • 4 Consumer Behavior
    • 4.1 Market Trends
    • 4.2 Pricing Analysis
    • 4.3 Buyer Insights
  • 5 Key Player Profiles
    • 5.1 Medtronic
      • 5.1.1 Business Overview
      • 5.1.2 Products & Services
      • 5.1.3 Financials
      • 5.1.4 Recent Developments
      • 5.1.5 SWOT Analysis
    • 5.2 Getinge AB
      • 5.2.1 Business Overview
      • 5.2.2 Products & Services
      • 5.2.3 Financials
      • 5.2.4 Recent Developments
      • 5.2.5 SWOT Analysis
    • 5.3 LivaNova PLC
      • 5.3.1 Business Overview
      • 5.3.2 Products & Services
      • 5.3.3 Financials
      • 5.3.4 Recent Developments
      • 5.3.5 SWOT Analysis
    • 5.4 Abiomed, Inc.
      • 5.4.1 Business Overview
      • 5.4.2 Products & Services
      • 5.4.3 Financials
      • 5.4.4 Recent Developments
      • 5.4.5 SWOT Analysis
    • 5.5 Nipro Corporation
      • 5.5.1 Business Overview
      • 5.5.2 Products & Services
      • 5.5.3 Financials
      • 5.5.4 Recent Developments
      • 5.5.5 SWOT Analysis
    • 5.6 ReliantHeart, Inc.
      • 5.6.1 Business Overview
      • 5.6.2 Products & Services
      • 5.6.3 Financials
      • 5.6.4 Recent Developments
      • 5.6.5 SWOT Analysis
    • 5.7 Terumo Corporation
      • 5.7.1 Business Overview
      • 5.7.2 Products & Services
      • 5.7.3 Financials
      • 5.7.4 Recent Developments
      • 5.7.5 SWOT Analysis
    • 5.8 Abbott Laboratories
      • 5.8.1 Business Overview
      • 5.8.2 Products & Services
      • 5.8.3 Financials
      • 5.8.4 Recent Developments
      • 5.8.5 SWOT Analysis
    • 5.9 CardiacAssist, Inc.
      • 5.9.1 Business Overview
      • 5.9.2 Products & Services
      • 5.9.3 Financials
      • 5.9.4 Recent Developments
      • 5.9.5 SWOT Analysis
    • 5.10 Thoratec Corporation
      • 5.10.1 Business Overview
      • 5.10.2 Products & Services
      • 5.10.3 Financials
      • 5.10.4 Recent Developments
      • 5.10.5 SWOT Analysis
    • 5.11 SynCardia Systems, LLC
      • 5.11.1 Business Overview
      • 5.11.2 Products & Services
      • 5.11.3 Financials
      • 5.11.4 Recent Developments
      • 5.11.5 SWOT Analysis
    • 5.12 Boston Scientific Corporation
      • 5.12.1 Business Overview
      • 5.12.2 Products & Services
      • 5.12.3 Financials
      • 5.12.4 Recent Developments
      • 5.12.5 SWOT Analysis
    • 5.13 Edwards Lifesciences Corporation
      • 5.13.1 Business Overview
      • 5.13.2 Products & Services
      • 5.13.3 Financials
      • 5.13.4 Recent Developments
      • 5.13.5 SWOT Analysis
    • 5.14 MicroPort Scientific Corporation
      • 5.14.1 Business Overview
      • 5.14.2 Products & Services
      • 5.14.3 Financials
      • 5.14.4 Recent Developments
      • 5.14.5 SWOT Analysis
    • 5.15 Jiangsu Jisheng Medical Technology Co., Ltd.
      • 5.15.1 Business Overview
      • 5.15.2 Products & Services
      • 5.15.3 Financials
      • 5.15.4 Recent Developments
      • 5.15.5 SWOT Analysis
  • 6 Market Segmentation
    • 6.1 Circulatory Support Devices Sales Market, By User
      • 6.1.1 Hospitals
      • 6.1.2 Specialty Clinics
      • 6.1.3 Ambulatory Surgical Centers
    • 6.2 Circulatory Support Devices Sales Market, By Application
      • 6.2.1 Hospitals
      • 6.2.2 Ambulatory Surgical Centers
      • 6.2.3 Cardiology Centers
      • 6.2.4 Others
    • 6.3 Circulatory Support Devices Sales Market, By Product Type
      • 6.3.1 Ventricular Assist Devices
      • 6.3.2 Intra-Aortic Balloon Pumps
      • 6.3.3 Extracorporeal Membrane Oxygenation Systems
      • 6.3.4 Total Artificial Heart
      • 6.3.5 Others
    • 6.4 Circulatory Support Devices Sales Market, By Distribution Channel
      • 6.4.1 Direct Sales
      • 6.4.2 Distributor Sales
  • 7 Competitive Analysis
    • 7.1 Key Player Comparison
    • 7.2 Market Share Analysis
    • 7.3 Investment Trends
    • 7.4 SWOT Analysis
  • 8 Research Methodology
    • 8.1 Analysis Design
    • 8.2 Research Phases
    • 8.3 Study Timeline
  • 9 Future Market Outlook
    • 9.1 Growth Forecast
    • 9.2 Market Evolution
  • 10 Geographical Overview
    • 10.1 Europe - Market Analysis
      • 10.1.1 By Country
        • 10.1.1.1 UK
        • 10.1.1.2 France
        • 10.1.1.3 Germany
        • 10.1.1.4 Spain
        • 10.1.1.5 Italy
    • 10.2 Asia Pacific - Market Analysis
      • 10.2.1 By Country
        • 10.2.1.1 India
        • 10.2.1.2 China
        • 10.2.1.3 Japan
        • 10.2.1.4 South Korea
    • 10.3 Latin America - Market Analysis
      • 10.3.1 By Country
        • 10.3.1.1 Brazil
        • 10.3.1.2 Argentina
        • 10.3.1.3 Mexico
    • 10.4 North America - Market Analysis
      • 10.4.1 By Country
        • 10.4.1.1 USA
        • 10.4.1.2 Canada
    • 10.5 Middle East & Africa - Market Analysis
      • 10.5.1 By Country
        • 10.5.1.1 Middle East
        • 10.5.1.2 Africa
    • 10.6 Circulatory Support Devices Sales Market by Region
  • 11 Global Economic Factors
    • 11.1 Inflation Impact
    • 11.2 Trade Policies
  • 12 Technology & Innovation
    • 12.1 Emerging Technologies
    • 12.2 AI & Digital Trends
    • 12.3 Patent Research
  • 13 Investment & Market Growth
    • 13.1 Funding Trends
    • 13.2 Future Market Projections
  • 14 Market Overview & Key Insights
    • 14.1 Executive Summary
    • 14.2 Key Trends
    • 14.3 Market Challenges
    • 14.4 Regulatory Landscape
Segments Analyzed in the Report
The global Circulatory Support Devices Sales market is categorized based on
By Product Type
  • Ventricular Assist Devices
  • Intra-Aortic Balloon Pumps
  • Extracorporeal Membrane Oxygenation Systems
  • Total Artificial Heart
  • Others
By Application
  • Hospitals
  • Ambulatory Surgical Centers
  • Cardiology Centers
  • Others
By Distribution Channel
  • Direct Sales
  • Distributor Sales
By User
  • Hospitals
  • Specialty Clinics
  • Ambulatory Surgical Centers
By Region
  • North America
  • Europe
  • Asia Pacific
  • Latin America
  • Middle East & Africa
Key Players
  • Medtronic
  • Abbott Laboratories
  • Boston Scientific Corporation
  • Terumo Corporation
  • Getinge AB
  • CardiacAssist, Inc.
  • ReliantHeart, Inc.
  • SynCardia Systems, LLC
  • MicroPort Scientific Corporation
  • Nipro Corporation
  • Abiomed, Inc.
  • Jiangsu Jisheng Medical Technology Co., Ltd.
  • Thoratec Corporation
  • Edwards Lifesciences Corporation
  • LivaNova PLC
  • Publish Date : Jan 21 ,2025
  • Report ID : AG-22
  • No. Of Pages : 100
  • Format : |
  • Ratings : 4.7 (99 Reviews)
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