Picard Medical, Inc. · AMEX:PMI
Picard Medical — FY2025 Earnings Presentation
56 slides from Picard Medical's earnings presentation, Mar 25, 2026
Slide 1: First Annual Business Update
NYSE: PMI First Annual Business Update March 25, 2026 SynCardia's products are approved for sale in the U.S. and Canada only. SynCardia Systems, LLC is a wholly owned subsidiary of Picard Medical Inc. © SynCardia Systems, LLC. All rights reserved.
Slide 2: Forward-Looking Statements
Forward-Looking Statements This Presentation contains statements that are “forward-looking statements” within the proceedings. Neither the Company nor any of its subsidiaries, affiliates, representatives or meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements a
Slide 3: Disclaimers
Disclaimers General: Picard Medical, Inc. (NYSE American: PMI) (the “Company”) is making this obtained from published and non-published sources prepared by third parties, which in presentation available in connection with an update on its business operations, certain cases have not been independentl
Slide 4: Our Mission
To pioneer the future of heart Our Mission replacement by providing the world’s first Total Artificial Heart and developing the next-generation system as an alternative to transplantation SynCardia's products are approved for sale in the U.S. and Canada only. SynCardia Systems, LLC is a wholly owned
Slide 5: Agenda
Agenda Agenda Item Speaker Welcome, Introductions and Strategic Overview Patrick NJ Schnegelsberg, Chief Executive Officer Technology and Product Pipeline Matt Schuster, Chief Operating Officer Operational Strategy Matt Schuster, Chief Operating Officer Financial Overview Bernard Skaggs, Chief Finan
Slide 6: Dr. Amy Feidler, M.D.
Dr. Amy Feidler, M.D. • Cardiothoracic surgeon specializing in heart transplantation and mechanical circulatory support • Associate Professor of Surgery and Surgical Director Heart Transplantation and Mechanical Circulatory Support, UCSF • Completed surgical training at Massachusetts General Hospita
Slide 7: Dr. Zain Khalpey, MD, PhD, FACS
Dr. Zain Khalpey, MD, PhD, FACS • Cardiothoracic surgeon specializing in advanced heart failure and mechanical circulatory support • Chief Medical Artificial Intelligence Officer and Network Director, Artificial Heart Program HonorHealth, Phoenix • M.D., Guy’s, King’s & St Thomas’ School of Medicine
Slide 8: Marcela P.
Marcela P. • Diagnosed with Postpartum Cardiomyopathy • Received a SynCardia Total Artificial Heart (STAH) as a bridge to transplant • Spent about 9 months on the device • Successful heart transplant Sources: Marcela P. and SynCardia Systems LLC Disclosure: The patient featured is an individual case
Slide 9: Opening and Strategic Overview
Opening and Strategic Overview Patrick NJ Schnegelsberg, CEO
Slide 10: Advanced Heart Failure: A Major Unmet Need
Advanced Heart Failure: A Major Unmet Need The Problem The Gap Our Leadership Many patients require Established clinical Donor heart supply biventricular circulatory platform and bridge to remains severely limited support transplant solution • ~6.8 million people live with • Only ~4,500 heart • SynC
Slide 11: SynCardia: A Proven Platform with a Path to the Future
SynCardia: A Proven Platform with a Path to the Future Tech Advantage Clinical Validation Future Platform Purpose Built for Built on Decades of Building on the SynCardia Biventricular Support Clinical Experience Ventricular Platform Most mechanical circulatory • First implants performed in • Develop
Slide 12: SynCardia Total Artificial Heart Platform Ecosystem
SynCardia Total Artificial Heart Platform Ecosystem Hospital & Home Drivers Driveline Centers of Accessories & Excellence Services Clinical Clinical Support Training SynCardia TAH Sources: Picard Medical Inc SEC filings & SynCardia Systems LLC. SynCardia's products are approved for sale in the U.S.
Slide 13: Key Achievements in 2025
Key Achievements in 2025 Commercial Technology Global Market Manufacturing Corporate Progress Advancement Development and Operations • Successfully • Revenue • Continued • Continued • Initiated transfer completed initial increased 12.3% development of progress on of key public offering • U.S. now th
Slide 14: Strategy for Growth in Artificial Heart Therapy
Strategy for Growth in Artificial Heart Therapy Advance Next Generation Artificial Heart Technology Fully implantable Emperor Total Artificial Heart Expand Clinical Autoregulating Expand Global Market Adaptation electromechanical design Access Next generation driver technologies Regulatory approvals
Slide 15: Technology and Product Pipeline
Technology and Product Pipeline Matt Schuster, COO
Slide 16: Technology Leadership in Total Artificial Hearts
Technology Leadership in Total Artificial Hearts 2004 Patient Hospitalized FDA approves 70cc STAH 2012 Patient Mobile in Hospital FDA approves Companion C2 Driver 2014 Patient Mobile in Home FDA approves First company to Freedom Driver 2020 Children & Small Adults receive TAH approval by FDA FDA app
Slide 17: Emperor Total Artificial Heart
Emperor Total Artificial Heart • Development of a fully implantable artificial heart platform designed to eliminate external pneumatic drivers • Designed to preserve surgical placement and physiologic performance of the current SynCardia Goal: Fully Implantable Power system and Control Architecture
Slide 18: Mechanism of Action
Mechanism of Action • Volume displacement diaphragm pump replacing both ventricles and all four heart valves • Partial fill full eject cycle based on the Frank Starling principle • Automatic adjustment of cardiac output in response to changes in preload and afterload • Physiologic pumping mechanism
Slide 19: Hemodynamic Performance
Hemodynamic Performance Emperor Exhibits Frank-Starling Autoregulation • Bench testing demonstrates hemodynamic 7 characteristics consistent with the SynCardia 6 platform 5 • Equivalent stroke volume, cardiac output, and wash characteristics observed Cardiac 4 Output • Demonstrates autoregulation in
Slide 20: Preclinical Feasibility Testing
Preclinical Feasibility Testing Emperor Exhibits Emperor Exhibits in Vivo Autoregulation • Successfully implanted in multiple porcine models • Animals separated from bypass without complications • Device provided stable circulatory support during observation period • Hemodynamic performance consiste
Slide 21: Development Roadmap
Development Roadmap Emperor Gen 1 Concept • 2026 – Continued acute animal studies – Design iteration and reliability testing – Potential submission for FDA Breakthrough Device Designation • 2027 – Design freeze – Initiation of GLP animal studies • 2028 – Completion of verification and validation tes
Slide 22: Unicorn Driver – Next Generation Portable Artificial Heart System
Unicorn Driver – Next Generation Portable Artificial Heart System • Next generation portable pneumatic driver system • Intended to reduce size and Unicorn weight relative to the Freedom driver • Designed to improve battery life, usability, and patient mobility • Potential manufacturing cost advantag
Slide 23: Artificial Heart Innovation Pipeline
Artificial Heart Innovation Pipeline Platform Purpose Status Proven bridge to SynCardia Total transplant therapy Commercial (FDA) Artificial Heart replacing both ventricles Next generation driver Unicorn Portable reducing size, weight Development (Bench) Driver and cost Fully implantable artificial
Slide 24: Operational Strategy and Manufacturing Initiatives
Operational Strategy and Manufacturing Initiatives Matt Schuster, COO
Slide 25: Operational Initiatives to Support Scale and Improve Margins
Operational Initiatives to Support Scale and Improve Margins Manufacturing Supply Chain Vertical Integration Optimization Resilience Driver Manufacturing Valve Assembly Moved In- Second Source Transfer to China House Qualification • Allows U.S. team to focus • Eliminates reliance on on implant innov
Slide 26: Financial Overview
Financial Overview Bernard Skaggs, CFO
Slide 27: Revenue Growth Driven by U.S. Adoption of the SynCardia platform
Revenue Growth Driven by U.S. Adoption of the SynCardia platform Revenues by Year and Region ($MM) • Revenue increased 12.3 percent year 6 over year to $4.94 million 5 • U.S. revenue grew 33.5 percent, representing 88 percent of total 4 revenue 3 • Product revenue increased 11.6 percent to $4.75 mil
Slide 28: Deployment of Capital Raised in 2025
Deployment of Capital Raised in 2025 Use of Funds • Majority of capital deployed to support ongoing (% of $35M Raised) operations and business growth • Legacy liabilities addressed, strengthening the company’s financial foundation 17% • Remaining capital reflects transaction costs associated with th
Slide 29: Operating Cash Burn Significantly Lower Than GAAP Net Loss
Operating Cash Burn Significantly Lower Than GAAP Net Loss • Approximately $27 million net loss Net Loss to Operating Cash Flow Bridge • Approximately $14.5 million in non-cash and ($ million) financing related items(primarily driven by Increase Decrease Total derivative accounting, amortization of
Slide 30: Balance Sheet Strengthened Following Capital Raise and Liability Reduction
Balance Sheet Strengthened Following Capital Raise and Liability Reduction Dec 31 2025 Dec 31 2024 % Change Cash $ 11,451 $ 96 11,828 • Additional paid in capital increased significantly Inventory $ 7,303 $ 8,115 -10 Other, current $ 1,972 $ 1,580 25 following IPO and financing Fixed assets $ 1,822
Slide 31: Capitalization and Fully Diluted Share Count
Capitalization and Fully Diluted Share Count Total shares outstanding 75,178,535 Warrants 7,710,280 Equity incentive plan 18,000,000 Fully diluted shares 100,888,815 Common shares authorized (1) 150,000,000 Preferred shares authorized 30,000,000 (1) (1) On March 10, 2026 the schareholders voted to i
Slide 32: Key Financial Priorities for 2026
Key Financial Priorities for 2026 Gross Margin Capital and Cost Revenue Growth Improvement Management • Expand U.S. • Improve gross • Strengthen implant margins through balance sheet volumes, the scale, through Company’s manufacturing additional highest margin efficiency, and capital and market rent
Slide 33: Experience with the SynCardia TAH
Experience with the SynCardia TAH Amy Fiedler, MD Associate Professor of Surgery, Surgical Director of Heart Transplantation and Mechanical Circulatory Support, UCSF
Slide 34: Total Artificial Heart: A Cardiac Surgeons Perspective
Total Artificial Heart A Cardiac Surgeons Perspective Amy G. Fiedler, MD Associate Professor of Cardiac Surgery Surgical Director of Heart Transplantation and Mechanical Circulatory Support
Slide 35: Objectives
Objectives Overview of our heart failure program at UCSF Describe our path to TAH and subsequent growth Review patient selection (key for success) Surgical technique Discuss our institutional outcomes to date Next steps for future growth and collaboration 35
Slide 36: AHFCCC – UCSF
AHFCCC – UCSF Advanced Heart Failure Comprehensive Care Center Top 8 heart transplant program in the US Largest VA ECMO program in the West 5th largest LVAD HM3 center in the West 36
Slide 37: Our journey to TAH
Our journey to TAH It takes a team… Busy LVAD center Busy transplant center Fantastic coordinators + nurses Innovative leadership Surgeons with experience 37
Slide 38: Patient Selection
Patient Selection Biventricular failure Age Status of end organs Multi-disciplinary evaluation Potential transplant candidacy in the future Rehabilitation potential 38
Slide 39: Patient Selection
Patient Selection 39 UCsF Health
Slide 40: Surgical Technique – Tips and Tricks
Surgical Technique – Tips and Tricks Minimize any unnecessary dissection Sew the aorta and PA grafts on first Double layer 3-0 MH prolene on sewing cuffs Loops around SVC, IVC, aorta Goretex + close pericardium Delayed chest closure until exquisitely dry 40
Slide 41: Institutional Outcomes to Date
Institutional Outcomes to Date Program began November 2024 5 TAH implants - 2 with successful OHT - 1 awaiting discharge - 2 expired 41
Slide 42: Success Stories
Success Stories UCsF Health
Slide 43: Success Stories
Success Stories COOK SURVIVING ON ARTIFICIAL HEART SAVED WITH DONOR HEART IN FIRST-EVER UCSF TRANSPLANT ey 97 #8 Dest and Juan Caos Guerero “Tuesday, March 17, 2026 10<7AM PT 43 UCsF Health
Slide 44: Next Steps for Growth / Collaboration
Next Steps for Growth / Collaboration SynCardia x UCSF UCSF to become a destination center for TAH Collaborative outreach events across the country promoting TAH x UCSF Partnering to publish outcomes, best practices, and practice changing techniques Discuss possibility of cross-collaboration
Slide 45: Thank you!
Thank you! 45 UCsF Health
Slide 46: Patient Perspective
Patient Perspective Former SynCardia Patient
Slide 47: Future of Mechanical Circulatory Support Innovation
Future of Mechanical Circulatory Support Innovation Zain Khalpey, MD, PhD, FACS Chief Medical Artificial Intelligence Officer, Network Director for the Artificial Heart Program, HonorHealth, Phoenix
Slide 48: Future of Mechanical Circulatory Support Innovation
Future of Mechanical Circulatory Support Innovation A physician’s perspective on the evolution of MCS and the future role of artificial hearts Zain Khalpey, MD, PhD o ae co a “ g/ ——- oO ») o = ==) - ] oO s)
Slide 49: MCS Has Evolved But the Gap Remains.
MCS Has Evolved But the Gap Remains. —,.22,, implantable systems 2010s: Total Artificial 2000s: Continuous-flow 1990s: First-generation 1960s: LVADs Intra-aortic balloon pump “Each generation solved the last generation’s problem and created the next one.” |
Slide 50: LVAD Therapy Leaves a Critical Population Behind.
LVAD Therapy Leaves a Critical Population Behind. ¢ Post-LVAD RV failure occurs in 20 to 40% of implants ¢ No approved durable solution for biventricular failure ¢ Temporary MCS bridges to nowhere without a definitive plan ¢ Escalation pathways remain fragmented ailure rather than solving it
Slide 51: Total Artificial Heart Fills the Biventricular Gap.
Total Artificial Heart Fills the Biventricular Gap. © Complete cardiac 0) replacement (no residual eS /9 Yo myocardium to fail) 7 : , Bridge-to-Transplant : Survival ° Balanced systemic and —— __ pulmonary flow by design — ei: & End-Organ Recovery © Ideal for BiV failure, failed a w LVAD, complex an
Slide 52: The Next Frontier: Intelligent, Fully Implantable Systems
The Next Frontier: Intelligent, Fully Implantable Systems ¢ Emperor platform for smaller profile and broader patient eligibility ¢ Fully implantable systems with no external driveline * The “Warp Speed” leap: Al-powered intelligent controllers * Destination therapy potential, not just bridge to tran
Slide 53: The Emperor Total Artificial Heart: Early Engineering Concept
The Emperor Total Artificial Heart: Early Engineering Concept ~ Fully implantable electromechanical artificial heart system in early engineering and preclinical evaluation ~ Designed to preserve the physiological autoregulation and hemodynamic performance of the SynCardia TAH « Eliminates the extern
Slide 54: Closing Remarks with Q&A
Closing Remarks with Q&A Patrick NJ Schnegelsberg, CEO
Slide 55: Key Strategic Priorities for 2026
Key Strategic Priorities for 2026 • Continued growth in U.S. adoption, which represents the Company’s highest margin geography • Ongoing development of the next generation technology platforms, including the fully implantable Emperor Total Artificial Heart • Operational initiatives focused on manufa
Slide 56: NYSE: PMI
SynCardia's products are approved for sale in the U.S. and Canada only. “Freedom” is a registered trademark of SynCardia Systems, LLC. “SynCardia Systems”, the SynCardia logo, “Giving the Gift of Time”, “Saving Lives, one Heart at a Time”, “Companion 2 Driver ” are trademarks of SynCardia Systems, L