Picard Medical, Inc. · AMEX:PMI
Picard Medical — Corporate Update (March 2026)
56 slides from Picard Medical's corporate update, Mar 27, 2026
Slide 1: First Annual Business Update
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. NYSE: PMI First Annual Business Update March 25, 2026
Slide 2: Forward-looking statements
This Presentation contains statements that are “forward - looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Forward - looking statements include all statements that do not relate solely to historical or current facts and can generally be identified by th
Slide 3: General disclosures
General: Picard Medical, Inc. (NYSE American: PMI) (the “Company”) is making this presentation available in connection with an update on its business operations, strategies, and financial results for the year ended December 31, 2025. The information contained in this presentation does not purport to
Slide 4: Our Mission
Our Mission To pioneer the future of heart 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 o
Slide 5: Speaker Agenda
Speaker Agenda Item Patrick NJ Schnegelsberg, Chief Executive Officer Welcome, Introductions and Strategic Overview Matt Schuster, Chief Operating Officer Technology and Product Pipeline Matt Schuster, Chief Operating Officer Operational Strategy Bernard Skaggs, Chief Financial Officer Financial Ove
Slide 6: Dr. Amy Fiedler, M.D.
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. • Cardiothoracic surgeon specializing in heart transplantation and mechanical circulatory support • Associ
Slide 7: Dr. Zain Khalpey, MD, PhD, FACS
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. • Cardiothoracic surgeon specializing in advanced heart failure and mechanical circulatory support • Chief
Slide 8: Marcela P.
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. • Diagnosed with Postpartum Cardiomyopathy • Received a SynCardia Total Artificial Heart (STAH) as a bridg
Slide 9: Opening and Strategic Overview
Opening and Strategic Overview Patrick NJ Schnegelsberg, CEO
Slide 10: Advanced Heart Failure: A Major Unmet Need
The Problem • ~6.8 million people live with heart failure in the United States • ~56 million globally • ~300,000 patients suffer from advanced heart failure in the United States The Gap • Only ~4,500 heart transplants annually in the United States • Over ~7,000 on the waiting list Our Leadership • S
Slide 11: SynCardia: A Proven Platform with a Path to the Future
Tech Advantage Most mechanical circulatory support technologies treat only one ventricle: • LVADs support the left ventricle • ECMO is temporary support • Temporary devices are short term stabilization tools SynCardia replaces both ventricles and all four heart valves Clinical Validation • First imp
Slide 12: SynCardia Total Artificial Heart Platform Ecosystem
Clinical Training Clinical Support Centers of Excellence 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. SynCardia Total Artificial Heart Platform Ecosyst
Slide 13: Key Achievements in 2025
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. Key Achievements in 2025 Corporate • Successfully completed initial public offering • $35.55 million total
Slide 14: Strategy for Growth in Artificial Heart Therapy
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. Strategy for Growth in Artificial Heart Therapy Expand Clinical Adaptation Increase implanting centers Str
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 FDA approves Companion C2 Driver FDA approves Freedom Driver FDA approves 50cc STAH US Patents covering fully implantable artificial hearts Patient Hospitalized Patient Mobile in Hospital Patient Mobile in Home Children & Small Adults Alternative to H
Slide 17: Emperor Total Artificial Heart
Emperor Total Artificial Heart 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. (1) US Patents: 11,918,798; 12,121,711 & China: CN 115279450 Sources: Picar
Slide 18: 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 similar to the nativ
Slide 19: Hemodynamic Performance
• Bench testing demonstrates hemodynamic characteristics consistent with the SynCardia platform • Equivalent stroke volume, cardiac output, and wash characteristics observed • Demonstrates autoregulation in response to changing atrial pressure • Maintains stable output across a range of physiologic
Slide 20: Preclinical Feasibility Testing
• Successfully implanted in multiple porcine models • Animals separated from bypass without complications • Device provided stable circulatory support during observation period • Hemodynamic performance consistent with design objectives Preclinical Feasibility Testing SynCardia's products are approv
Slide 21: Development Roadmap
• 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 testing – Potential initiation of U.S. clinic
Slide 22: Unicorn Driver – Next Generation Portable Artificial Heart System
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. Unicorn Driver – Next Generation Portable Artificial Heart System • Next generation portable pneumatic dri
Slide 23: Artificial Heart Innovation Pipeline
Status Purpose Platform Commercial (FDA) Proven bridge to transplant therapy replacing both ventricles SynCardia Total Artificial Heart Development (Bench) Next generation driver reducing size, weight and cost Unicorn Portable Driver Preclinical (Animals) Fully implantable artificial heart for long
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
Manufacturing Optimization • Allows U.S. team to focus on implant innovation • Supports lower manufacturing cost • Reduces component obsolescence risk Vertical Integration • Eliminates reliance on external supplier • Improves precision control of valve tolerance • Reduces manufacturing lead time Sup
Slide 26: Financial Overview
Financial Overview Bernard Skaggs, CFO
Slide 27: Revenue Growth Driven by U.S. Adoption
• Revenue increased 12.50 percent year over year to $4.94 million • U.S. revenue grew 33.49 percent, representing 88.25 percent of total revenue • Product revenue increased 11.57 percent to $4.75 million and represents 96.07 percent of total revenue Revenue Growth Driven by U.S. Adoption of the SynC
Slide 28: Deployment of Capital Raised in 2025
Balance Sheet Cleanup • Repayment of legacy debt and settlement of outstanding accounts payable to stabilize the balance sheet. Transaction and Financing Costs • IPO and financing expenses associated with becoming a public company and securing institutional capital Business Operations and Growth • O
Slide 29: Net Loss to Operating Cash Flow Bridge
• Approximately $27.00 million net loss • Approximately $14.53 million in non - cash and financing related items(primarily driven by derivative accounting, amortization of debt discount, and other financing related charges) • Approximately $(3.20) million in net working capital changes reflecting ti
Slide 30: Balance Sheet Strengthened Following Capital Raise
Balance Sheet Strengthened Following Capital Raise and Liability Reduction 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. (1) (1) n/m (not meaningful) be
Slide 31: 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 SynCardia's products are approved for sale in the U.S. and Canada only. SynCardia Systems, LLC is a
Slide 32: Key Financial Priorities for 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. Key Financial Priorities for 2026 Sources: Picard Medical Inc SEC filings & SynCardia Systems LLC. Revenue
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: A Cardiac Surgeon's Perspective
Amy G. Fiedler, MD Associate Professor of Cardiac Surgery Surgical Director of Heart Transplantation and Mechanical Circulatory Support Total Artificial Heart A Cardiac Surgeons Perspective
Slide 35: Objectives
35 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
Slide 36: UCSF Advanced Heart Failure Comprehensive Care Center
36 AHFCCC – UCSF Advanced Heart Failure Comprehensive Care Center ▪ Top 8 heart transplant program in the US ▪ Largest VA ECMO program in the West ▪ 5 th largest LVAD HM3 center in the West
Slide 37: Our journey to TAH
37 Our journey to TAH It takes a team… ▪ Busy LVAD center ▪ Busy transplant center ▪ Fantastic coordinators + nurses ▪ Innovative leadership ▪ Surgeons with experience
Slide 38: Patient Selection
38 Patient Selection ▪ Biventricular failure ▪ Age ▪ Status of end organs ▪ Multi - disciplinary evaluation ▪ Potential transplant candidacy in the future ▪ Rehabilitation potential
Slide 39: Patient Selection
Patient Selection 39 UCsF Health
Slide 40: Surgical Technique – Tips and Tricks
40 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
Slide 41: Institutional Outcomes to Date
41 Institutional Outcomes to Date Program began November 2024 ▪ 5 TAH implants - 2 with successful OHT - 1 awaiting discharge - 2 expired
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 ep 9742 Daotz and tan Caros Guero Tuesday, March 17, 2026 10;7AM PT 43 Use Health
Slide 44: Next Steps for Growth / Collaboration
44 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 - collabor
Slide 45: Thank you!
Thank you! 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 ee + oe i) s @- . me ———O * i») = KS iy s : = x Vu Y/, = 5 a ij, : os =D ie) 5)
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
Slide 51: Total Artificial Heart Fills the Biventricular Gap
Total Artificial Heart Fills the Biventricular Gap. é ° Complete cardiac 0) replacement (no residual a a 9 Yo myocardium to fail : ) Bridge-to-Transplant Survival * Balanced systemic and Sa . — pulmonary flow by design Ga End-Organ Recovery Ideal for BiV failure, failed _ (4 LVAD, complex anatomy (
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 — \ oo * The “Warp Speed” leap: ey Al-powered intelligent We controllers j_/ ¢ Destination therapy potential,
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
• 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 manufacturing efficiency, supply chain r
Slide 56: About SynCardia Systems, LLC
About SynCardia Systems, LLC SynCardia Systems, LLC, a Picard Medical Company, is headquartered in Tucson, AZ. We manufacture and distribute the world’s f irs t and only US Food and Drug Administration (FDA) and Health Canada approved total artificial heart. The SynCardia Total Artificial Heart is t