Good day, and thank you for standing by. Welcome to the MicroPort fourth annual results English conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star one on your telephone. Please be advised that today's conference is being recorded. If you require any further assistance, please press star zero. I would now like to hand the conference over to your speaker today, Ms. Yolanda Hu. Please go ahead.
Thank you. Good morning and good evening, everyone. Thanks for joining today's call. Management from MicroPort for the call today include CFO, Mr. Martin Sun, our Chief Technology Officer, Dr. Qiyi Luo, Chief International Business Officer, Mr. Jonathan Chen, Vice President and Board Secretary, Ms. Leanne Li. Now I'll hand over to Jonathan to start the presentation. Jonathan, please.
Yeah. Thank you, Yolanda. Welcome everyone to the 2021 annual results conference call for MicroPort Scientific. As Yolanda mentioned, we have today with us several colleagues of mine to present the annual results. Shortly after this call, we will have the English investor calls for MicroPort CardioFlow and MicroPort MedBot separately to give you more details about our other two listed subsidiaries. During the next hour, Martin and I will provide comments on our annual results for 2021 and the outlook for 2022. After our prepared remarks, we'll be happy to take your questions. Unless otherwise mentioned, reference to the year-over-year changes are given in constant currency basis, adjusted for the impact of foreign currency translation. First, I will give a business overview.
As many of you know, MicroPort is a world-leading innovative high-end medical device group. Since our establishment in 1998, with our unremitting pursuit of independent innovation and industry-leading commercialization capabilities, we are committed to building a conglomerate of people-centric enterprises of emerging medical technologies. We have achieved steady development of our global business for many years. Up to now, we have 12 business clusters covering six major organ systems of the human body, including circulatory, nervous, exercise, endocrine, urinary, and reproductive systems. With 24 years of rapid development, we have attained leading market positions in many segments domestically and globally. First of all, let me introduce our total cardio solutions consisting of four segments, including our cardiovascular CRM, structural heart disease subsidiaries, and associated electrophysiology subsidiary.
Recently, we noted a visible trend in the global medical device industry that companies are pursuing more comprehensive solutions to all cardio-related diseases, and MicroPort is undoubtedly a world-leading company in this field. For the cardiovascular business, our DES market share ranks number top two globally and top one in China. In terms of our CRM business, we are one of only five multinational companies in the industry, and we are the largest Chinese company and rank fourth among all players in terms of the domestic market share. In our structural heart business, we have a leading TAVI market share in China. In our electrophysiology business, we are one of the few manufacturers around the globe that can provide a complete solution for 3D electrophysiological equipment and consumables, with the largest market share in the domestic 3D EP mapping market.
In the future, we will continue to integrate our global networks and resources accumulated from each subdivision with the total cardio solutions and further leverage the strong synergies in market access and promotion of total solutions. In our endovascular business, we are one of the top five players globally and the market leader in China. In our neurovascular business, we are one of the pioneers and leading companies in the global neurointerventional industry, and we are the largest Chinese company in this segment and with the most comprehensive product portfolio. In our surgical robot business, we are one of the world's only surgical robot company with a product portfolio covering five major and fast-growing surgical specialties. In particular, Toumai is the first and only domestic four-armed laparoscopic surgical robot approved for commercialization.
It is also the second laparoscopic surgical robot in the world and the first in China that can comprehensively cover thoracic, abdominal, and pelvic cavities. Our Honghu orthopedic surgical robot is the first China-made surgical robot submitted for the FDA registration. In orthopedics and sports medicine, we are one of the leading companies in the global orthopedic market, and our market share in China has experienced steady growth over the years. Our self-developed, and the world's first long-term implantable balloon rotator cuff spacer system has launched clinical trials in China. In our surgical device business, where the world's fully integrated, non-powered and portable echo system has obtained the CE mark. Now I'll review some of our performance highlights in 2021. In 2021, we had remarkable progress in our global business expansion and recorded outstanding performance across all segments.
Despite the spread of COVID-19 pandemic and an unstable macro environment, we achieved global revenue growth of 15% year-on-year to $779 million in total revenue. In particular, our Heart Valve business, our neurovascular business, and our endovascular business continued their strong growth trend with revenue significantly increased by 93%, 73%, and 46% respectively. Last year, the group recorded a loss attributed to equity shareholders of $276 million, and mainly due to the following. First, the impact of large R&D and market expenditure for our two listed subsidiaries, named MedBot and CardioFlow, which amounted to $122 million. Two, the impact of volume-based procurement of coronary stents affecting gross profit by $37 million.
3, the expenditure of our overseas market development and product promotion, which totaled $85 million. Fourth, the one-off and non-cash cost of $97 million, which mainly included listing expenses of subsidiaries, financing costs of convertible bonds, and share-based costs, et cetera. In our 2021, our international business developed rapidly in all of our geographies. In South America, EMEA, and North America, we recorded significant revenue growth of 3%, 18%, and 7% respectively. In particular, excluding the contribution from our orthopedics and CRM businesses, we had robust sales growth of 28% year-on-year from our other business segments. By segment, the cardiovascular business had overseas revenue growth of 35%, including 136% growth from EMEA and 18% growth from our South America markets.
The revenue of our CRM business increased by 13% in the EMEA market and more than doubled in Japan, which is a high-margin direct sale market. Our orthopedic business recorded revenue growth of 28%, 7%, and 7% in EMEA, U.S., and Japan respectively. The endovascular business had a record high revenue growth of over 100% from overseas sales. In terms of market development in India, we successfully launched Firehawk as our first locally manufactured coronary stent system in the overseas market. With our top-quality product and established local sales network, we aim for fast penetration into the Indian market, which has huge potential.
In North America, the group plans to set up an American headquarters and an intelligent manufacturing base in Southern California in order to improve the capabilities of our clinical registration, manufacturing, and commercialization in the international market for all of our business segments. In addition, our endovascular product has attained five CE marks and covered 18 overseas markets. Our neurovascular business had built local sales networks into Europe, North America, Latin America, and Asia Pacific and achieved commercial implantations overseas. Lastly, our TAVI products also have multiple commercial implantations overseas, with business expanding into the Latin America market. In terms of overseas R&D, the clinical trials for multiple products, including Firehawk Stent and the Invicta Defibrillation Lead, all had smooth progress. Each of our neurovascular business, heart valve business, and surgical robots business had core products approved overseas or submitted registration for CE mark or FDA approval.
In terms of financing and international cooperation in 2021, the group raised approximately $1.57 billion from external financing. MicroPort CardioFlow and MicroPort MedBot both had successful IPOs in the Hong Kong Stock Exchange. In addition, our MicroPort NeuroTech has submitted IPO application to the Hong Kong Stock Exchange, and our associated company, MicroPort EP MedTech, has steadily progressed for its IPO on the Sci-Tech Innovation Board on the Shanghai Stock Exchange. At the same time, the group also actively carried out strategic cooperation around the world in various aspects and have achieved remarkable results in cooperative R&D projects, as well as the integration of sales channels and our market resources. Now I'll review some R&D highlights. As a world-leading innovative high-end medical device group, MicroPort attaches great importance to innovative research and development.
Our R&D expenses in the year of 2021 reached $298 million, representing a year-on-year increase of 55%. For year to date, we had a total of 22 products approved by NMPA and five innovative product candidates admitted to the special review procedure of NMPA, also known as the Green Path. Cumulatively, our group has 26 products that have been admitted to the Green Path, ranking first among all Chinese medical device companies for seven consecutive years. In overseas markets, 15 products attained CE marking and seven products were approved by the FDA. Our R&D investment during the year is mainly reflected in the following aspects.
For the cardiovascular business, our TARGET series clinical trial of Firehawk Stent has steadily progressed, which is expected to complete patient enrollment this year, and we target to attain FDA approval for Firehawk by 2024. In addition, we have completed the patient enrollment for the pre-market clinical trial for Firesorb, our bioresorbable scaffold system, which is expected to attain NMPA approval between 2023 and 2024. For our CRM business, seven products attained CE mark. Our pacemakers equipped with Bluetooth technology were approved by launching in Europe and in Japan, and we completed the clinical trial of our ICD lead Invicta ahead of schedule and submitted registration for CE marking, which will become a major breakthrough in our product portfolio of implantable defibrillation systems.
In China, we have submitted the registration application for Rega, the first made-in-China out-of-chest MRI compatible pacemaker. Our Beflex pacing lead as well as Platinium ICD and CRT-D, which are expected to be approved in the first half of 2022. For our heart valve business, the second generation of our TAVI product, called VitaFlow Liberty, has been approved by the NMPA. Being the only TAVI product that is developed in China and has carried out clinical trials in Europe, our VitaFlow Liberty has been submitted for CE mark. For our endovascular business, two Green Path products, namely the Fontus branch surgical stent graft and the Talos thoracic stent graft, obtained NMPA approval. In addition, the venous stent system has completed patient enrollment for its pre-market clinical trial and has been admitted to the Green Path, being the sixth product admitted to the Green Path in this product segment.
In the field of interventional oncology, the key product TIPS stent graft has completed animal studies and entered into a type inspection stage. For our neurovascular business, our Numen coil products obtained CE mark and FDA approval. In China, three products obtained NMPA approval, including our Neurohawk stent thrombectomy device, Numen Silk, a new generation of coil product, and our Diveer intracranial balloon dilatation catheter. In addition, we have submitted the registration application for Tigertriever revascularization device to the NMPA. For our surgical robot business, our Toumai laparoscopic surgical robot has completed all surgical cases in the multidisciplinary, multicentered registrational clinical trial. Our Toumai single arm has completed the first-in-man trial, and our Honghu orthopedic surgical robot has submitted registration application both to the NMPA and FDA.
In addition, the peripheral vascular and percutaneous surgical robots have both entered into the registration clinical trial stage. For our orthopedic business, we have five products that have attained CE mark, and five products were approved by the FDA. In China, we also have five products approved by the NMPA, including the zirconium niobium alloy femoral head was admitted to the Green Path status. For the surgical device business, the Vitasprings membrane oxygenator has completed the clinical trial and was admitted to the Green Path. The femoral artery arterial and venous cannulas is also undergoing design verification.
To give you a brief summary, we expect the following key products to be approved in 2022, namely our Honghu orthopedic surgical robot, our Rega out-of-chest MRI compatible pacemaker, our Platinium ICD and CRT-D, as well as our Tigertriever revascularization device, all to be approved by the NMPA. In our overseas market, we target to obtain FDA approval for our Honghu orthopedic surgical robot, as well as the Alizea and Borea series pacemakers equipped with Bluetooth technology. I'll review the performance of each business segment for 2021. In our cardiovascular business, recorded revenue of $140 million, with the stent sales volume exceeding 1.22 million units, which was up 132% year-on-year.
Our domestic stent market share increased to about 50% after the national volume-based procurement, which covered nearly 3,000 hospitals nationwide. The revenue of our balloon and accessory products recorded a year-on-year growth of 48%, and our medical digital subtraction angiography, or DSA device, obtained approval during the year. We have started the commercialization of our OCT product, further enhancing our layout of our vascular interventional imaging products. Our CRM business recorded overall revenue of CNY 220 million, which was up 19% year-on-year. Sales in China increased by 54% year-on-year, with nearly 8% market share as we maintain strong leadership amongst domestic players. Our endovascular business has recorded strong revenue and profit growth for 5 consecutive years, including 46% revenue growth and 47% profit growth last year.
Our aortic products had a domestic market share of approximately 30%, being the number one amongst all domestic players for many years. The Neurovascular business has maintained rapid revenue growth and solid profitability for six consecutive years, with 73% revenue growth last year. Our commercialized product portfolio has covered all the 3 major areas of neurovascular disease, with number one market share amongst all domestic players. We also have achieved overseas sales revenue, with products being commercially implanted in Chile, which marks a major step towards our international business expansion for this market segment. The Heart Valve business recorded a year-on-year growth of 93%, with gross margin expansion of 15 percentage points. Our product pipeline has strategically covered all major solutions for heart valve disease.
Moreover, our TAVI products have been approved and sold in Argentina, adding a new growth driver for overseas sales for this segment. In our surgical robot business, the first commercialized product, the DFVision 3D electronic laparoscope, has started to generate sales revenue, and our Toumai laparoscopic surgical robot has been approved for marketing in China. In addition, we have established over 10 training centers for surgical robots nationwide and trained nearly 300 medical staff during the year, laying a solid foundation for the large scale product commercialization in China for the coming future. In the orthopedic business, despite the impact of the global pandemic, we reported global revenue growth of 5% year-on-year, with loss significantly narrowed by 57%.
In China, both of our hip and knee products have won national bidding, volume-based procurement, and our trauma products also won the bidding for volume-based procurement at the 12 provincial alliance. Our revenue from spine and trauma increased by 40% year-on-year in 2021. Now, I'll speak a little bit about our emerging businesses. While enjoying rapid growth from the relatively mature businesses, we are also actively expanding into emerging business areas, such as natural orifice intervention, rehabilitation, endocrinology, IVD, sports medicine, assisted reproduction, etc. In the field of natural orifice intervention, we introduced or we continue to improve our strategic layout in the fields of urology, respiration, gynecology, digestion, and gynecology with 16 certified products in total. Our first endoscope product has been approved during the year, which was important breakthrough in this subdivided segment.
The prosthetic wrist system was also admitted to the NMPA Green Path. In the field of rehabilitation, we mainly focus on muscle and bone rehabilitation, cardiopulmonary rehabilitation, and neurological rehabilitation. We have a total of six approved products with multiple product lines and obtained about 100 patents. The first powered product, cryothermal compression device, was approved in China. In the field of endocrinology, we focus on building a management platform for blood glucose, chemotherapy, pain management for patients with the core microfusion technology. The first chemotherapy infusion pump, AutoEx, has been approved for launching into the China market. In the fields of sports medicine, the world's first long-term implantable rotator cuff spacer system called Archimedes was developed by our associated company and has commenced clinical trials. In addition, we have four products approved in this segment.
In our assisted reproductive business, our self-developed Orkid intrauterine insemination catheter and Lotus, our ovum aspiration needle, were approved in China, together with two products approved in Thailand. With our strong innovation ability and synergies from our group operation, some of our emerging businesses have achieved commercialization and started to generate revenue. In the future, we are committed to building a comprehensive business portfolio from disease prevention and diagnosis to treatment and rehabilitation that covers the entire life cycle of human beings. That's all for the operating performance for the year 2021. I will now turn it over to our CFO, Martin Sun, to provide you with further details, financial details for our annual results and the outlook for year 2022. Martin?
Okay, thanks, Jonathan . Hi, good morning and good evening, everyone. This is Martin Sun, the CFO of MicroPort Group. I will now take you through our financial performance of 2021 and the guidance for 2022. During our 2021, MicroPort generated total revenue of $778.6 million, up 20% year-on-year in US dollars, and up 15% at a constant currency base. As Jonathan DeDomenico already gave a very detailed introduction on each segment, I will now just want to highlight that despite the China VBP policy on coronary stents posed significant changes on our top line, the revenue of our remaining segment combined achieved substantial growth by 20% year-on-year, and by 19% compared to the 2019 pre-COVID level.
The fact that sales decline of the cardiovascular business was effectively mitigated by the outperformance of the remaining segments demonstrates our underlying business strengths and the advantage of our diversified portfolio. Our gross profit increased by 12.8% year-on-year as a result of the revenue growth, while the gross margin fell 400 basis points to 63.2%. It was driven by the VBP price decline on China coronary stents business. For our operating expenses, the first one, the distribution cost increased by 70% or $43.4 million. It was driven by the increase in marketing activities and the sales commission as a result of COVID-19 recovery.
Our administrative expenses increased by 47%, mainly attributable to increase the cost of new LTI scheme and increase the head count and staff cost. The group continued to reinforce our focus on R&D activities during the year, despite the unfavorable macro environment, as we believe that innovation is key to the long-term sustainable growth. Our total R&D expenses amounted to $297.8 million, amounting to 38% of total group revenue. Such increase was mainly attributable to accelerated investment in the surgical robotic business. If we excluding the surgical robotic spending, the other business collectively had an R&D to revenue ratio of 30%, which is in line with our previous year level.
As a result of the above, the group made a net loss of $351.3 million. The loss attributable to the ordinary shareholders is $76.5 million. Moving on to our balance sheet. During 2021, we have made important progress in the balance sheet associated with a series of major financing and investing events, which have a successful fundraising of $1.7 billion, financings during the year. First at the group level, the Listco company raised the net proceeds of around $700 million by issuing a five-year convertible bond.
At the individual segments, our heart valve business called CardioFlow, and the surgical robotic called the MedBot business successfully listed on the Hong Kong Stock Exchange, raising net proceeds of $357 million, and $222 million respectively. Other major fundraising include the $150 million for neurovascular and $150 million for the CRM business. The proceeds have helped improve the cash liquidity of the group and will be an important source of funds for supporting our expansive R&D pipeline. From the investment perspective, we and the management remain optimistic and the discipline when it comes to acquisition and equity investment that can create value in the form of scalable growth.
During the second half year, we completed a number of investments, such as the acquisition of Hemovent, Kerui Pharmaceutical and the Suzhou Argus. Our cash balance surged from $1 billion opening to $1.75 billion at the year-end. The gearing ratio increased from 17.4% in 2020 to 46.8% in 2021, driven by the convertible bond issuing. That was a quick financial review for the last year. I will now provide the guidance for 2022. Starting from our revenue, during 2021 and the Q1 this year, we have seen that the COVID-19 pandemic recovery continued to unfold at every corners. For 2022, it was expected.
It is expected that our business will continue to be adversely impacted by it to a certain extent. While the COVID-19 may not be fully behind us, bringing better hospital preparedness and increasing vaccination rates around the globe, we are optimistic about our top line performance for 2022, expecting an overall growth of 20%-25% year-on-year. I will share more details on each key segments. First one for cardiovascular. The national VBP tenders execution in 2021 has further strengthened our leading position with a share of 45% in the China coronary stent market. The management are very optimistic about the volume potential and expected a double-digit growth in the range of 13%-15%. That increase in income will come from four aspects.
First one, the Firehawk, our previously selected products that won the national VBP tender, achieved a record high volume of more than 1 million units in 2021. As the VBP policy helped accelerate our penetration into a lot more hospitals, we believe in further upside potential on top of the VBP guaranteed volume for Firehawk. Second is Firehawk, our premium DES products targeting at the mid and higher-end markets, is also expected to ramp up rapidly in volume, given its superior clinical data and our expanded hospital coverage. The third one that we believe our cardio accessories and balloon products will grow double digits around the 20% as they continue to gain traction among the surgeons.
The fourth is for our overseas DES market, despite the uncertainty brought by the COVID and impact, it is still expected that our non-China cardiovascular revenue will continue to grow steadily. That is our cardiovascular. Second one, let's move on to the CRM business. We estimate that revenue of the CRM business will grow by approximately 10% year-on-year, plus or minus. By geographic region, the revenue from the international CRM business is expected to grow steadily by high single digits in the range of 6%-9% above the general market growth. This will be driven by the launch of Alizea, our Bluetooth technology pacemaker, and organic growth in the key region like Europe and Japan.
Our China CRM business is expected to sustain its robust momentum with year-on-year revenue growth in the high 20s %. This will be driven by the rapid market penetration of made-in-China products, such as the Rega pacemaker and leads. Let's move to the orthopedics. During 2021 and the Q1 this year, in view of the recent market condition, we expect that revenue growth for the global orthopedics business in the range of 14%-16% higher than the average market growth. For the non-China markets, we expect the revenue growth will be in the range of 8%-10%. As mentioned earlier, the Omicron variant signals some uncertainty across the globe, especially in the U.S., EMEA and Japan, which are the largest market for our orthopedics products.
Russia and the Ukraine tensions will also have an adverse impact on our business. In China market, we expect top line growth above 50% through the VBP driven account expansion and commercial execution. This is coming from the two effects. First one, we have seen significant revenue increase in our spine trauma products as a result of the VBP tender execution in the past few quarters, and anticipate a further acceleration due to the recent three plus nine policy with implication for more widespread adoption by more provinces. Second, in view of such, when it comes to the Ortho Recon VBP tender, which is about to start execution in Q2 this year, we have confidence and see it as a positive opportunity for our Recon products to seize a greater market share by opening doors to the double numbers of hospitals.
Apart from these three largest segments mentioned above, namely the cardiovascular, CRM, orthopedics business, the remaining portfolio such as the endovascular, neurovascular and Havard, we still keep a very high double-digit growth. At the same time, for more detailed information about those segments, please refer to their separate announcement and guidance provided where available. In terms of the gross margin for this year, we expect it to be similar to last year at around 63.3%-64%. Despite the minor headwinds from the VBP price erosion in the orthopedics and the CRM segments in the China market, our overall margin will benefit from several favorable factors at the same time, such as one, economies of scale from the volume increase across the business.
The second point is continued improvement in the production efficiency and greater synergies. The third factor is favorable mix from faster growth of the high margin product segment, such as the Firehawk and the endovascular products and neurovascular products. Let's turn to the operating expenses. We expect no significant changes in distribution costs, which will still stay at approximately 38% of the revenue. Our administrative, our admin expenses will decline to 27%-29% of the revenue versus 31% of last year, representing a better efficiency year on year, we continue the cost control and leverage our global resources. Armed with our equity fund successfully raised, we will be further accelerating our investment in R&D broadly across the group. Full year R&D expenses are expected to be at 37%-39% of group revenue.
A significant portion again will be devoted to the surgical robotics business and R&D business for pipeline development and overseas clinical trial, which will be supported by the cash position from successful IPO last year. Our other major increases are attributable to the cardiovascular segment to support their overseas clinical trials and also R&D in the emerging and also research in the emerging segments, as Jonathan Chen introduced earlier. That's all for our guidance on this year. Despite the volatility ahead around the COVID-19, COVID, macroeconomic conditions and market competition, we still remain optimistic about this year's outlook. We will continue to monitor that development and assess their impact, and we'll make a further announcement where necessary for significant changes to the forecast. Thank you for listening. I will now hand over to Yolanda Hu for the Q&A session. Thank you.
Thank you, Martin. Thanks, Jonathan. Operator, I think we are ready to take questions. Is there anyone on line?
Certainly. Once again, as a reminder, ladies and gentlemen, it is star followed by one on your telephone keypads if you wish to ask a question. Once again, it is star one to ask a question. We have a question coming from the line of Jason Liu from Credit Suisse. Please go ahead.
Hi there. Thanks management for taking my question. I have three questions here for the team. I'll go through them one by one. First question is around Honghu, especially the launch that is in the U.S. I was wondering if the team could share with us a little more as to how we are preparing for the launch in the U.S. Is there any synergy with the orthopedic segment in the U.S. even though we know it's different product types but still within orthopedics? Yeah, just wanted to see. That's my first question.
Yes, this is Jonathan here. I can respond to that. Thank you for that question, Jason. Yes. We are expecting to get the approval of our Honghu robotic system sometime in the first half of this year. We're going through the 510(k) process. We have a dedicated team to do the commercialization through MedBot. Obviously the commercialization of the Honghu robotic system is important to also have the involvement or knowledge of the knee implant itself coming from the MPO team. We will also involve key players for our MPO site to present the implantation or the implant expertise.
Got it. We're building up separate teams from MedBot versus, I guess, ortho, our ortho business in the U.S., right?
Yeah. Correct. It will be, you know, to support the system, the technical part for the Honghu robotic platform. That technical support, training support, marketing support, that will be provided by the MedBot team based in the U.S.
Okay. Got it. Thank you. My second question actually is on the China business and still around some of the synergy. Since we do know there are a lot of sales synergy between Endovastec and our Endovastec and our cardiovascular business, CardioFlow and our Endovastec business, and now MedBot also with other segments. Just wanted to hear more from management as to how these arrangements work in terms of sales sharing or are there contracts that are shared between our different businesses. That's my second question.
Sure. You're talking because some of our subsidiaries are public entities, public companies now, is that your question? How is the cooperation between those subsidiary businesses?
Yeah. Yeah.
Yes. Effectively because they're independent subsidiaries, independent companies, they do have, you know, arm's length arrangements, right, in terms of marketing or distribution between the two organizations. Because they're within the MicroPort ecosystem and they were all former colleagues of one another, there's a very smooth operation and smooth cooperation between the subsidiaries because of that, interactions of those previous interactions. For example, you know, for our China business, I think within you know cardiovascular group and with our TAVI group, you know, because stent business and TAVR business, ultimately those are the distribution channel. The clinicians that are putting in those devices are ultimately interventional cardiologists.
You can imagine that there's a lot of synergy and familiarity in terms of executing sales for stents and also for TAVI. In fact, some of our managers from our coronary business also have been involved in our TAVI business in the execution. You know, we made some management additions late last year, which we saw very strong results for the improvement of our TAVR sales in the second half of last year.
We always have those type of opportunities to leverage and synergies in terms of the operations, whether it's market access or, you know, sales execution, especially for those businesses that have very close overlap in terms of the end clinician.
Got it. It's very clear. I guess the last one for me is on financials. Thanks for sharing a lot of the guidance for a lot of these segments. I guess looking more ahead, is there any more details that the team can share about break even for some of these segments? Maybe on the group level again, when we may be able to see profit again. Thank you.
Okay.
Sure.
This is Martin, and thank you for your question about this, the profitability. I think it is because we still, for our, you know, the vascular business, including cardiovascular, neurovascular business and endovascular business, we are quite profitable. Although the cardiovascular business is, you know, negatively impacted by the VBP Plus policy execution in this year or last year, so we still make a profit last year.
I think for the other business, like, the MedBot just listed last year and cardiovascular, they are in the stage of their R&D spending, you know, to accelerate their new generation products to the market and the commercialization for their current, you know, with the NMPA licensed products. For these two business, we would think that's the breakeven point will still take a longer, maybe more than three years. The CI business and orthopedics business, and we believe this they are profitable, their breakeven point is within the two years. But it's still subject to the...
Because for these two business, there's overseas market and the revenues is much larger than the domestic China business. This is subject to the COVID-19's impact.
Got it. Thanks. I guess on the group level, do we have a thought there?
Group level, I think that's mainly depends on this all those you know business consolidations results. I would think that from management's perspective, it's you know and for this subsidiaries which is already listed in Hong Kong or the capital market. I think this is they will not how to say? Depends on our groups levels to continue investments. They have a sufficient proceeds to support their R&D spendings. I think exclude us when those heavily spending like MedBot and the CardioFlow, and even in the future, I think their CI business. Group level, our breakeven point that was still within the two years.
Okay. Got it. Thank you very much. I'll go back in the queue.
Operator.
Once again, as a reminder, it is star one to ask questions.
While we're waiting for the questions, I've actually got a few from email. The first question is, what is the expected cash burn in 2022 and 2023? What does your CapEx relate to? This is first question. The second question is, what is the risk of U.S.-China tension for you? 'Cause the U.S. business actually generated quite a significant amount of revenue from regions outside China. Can you share your thought?
Sure. Maybe I'll answer the first question or the second question first, the U.S.-China tensions, and Martin can provide some guidance on the 2022 cash burn and the CapEx. For our U.S.-China geopolitical relations, our U.S. business these days primarily is coming from our orthopedics business. Our U.S. orthopedics business is approximately $100 million in revenue, and still growing very nicely for us. So far, we do not see any significant impact to the business due to geopolitical issues. Obviously, the business in the U.S. have been impacted by COVID over the last two years. That has caused, that's probably the primary driver as opposed to geopolitical relations.
We will continue to monitor as the U.S. from a COVID standpoint seems to be improving, and the business across all industries, not just our medical device industry in the U.S., but across all industries, you know, get back to a more business normal environment. I think maybe where the U.S.-China geopolitical issues may have a larger impact is maybe on, in terms of, acquisitions or merger type of activity, particularly if they're larger projects or larger acquisitions. You know, I think that's true across all of the Western countries.
I think, you know, particularly for the last couple of years, because of geopolitical tensions, every country, every major country in the G7 have taken up a much stronger position in terms of reviewing foreign direct investments and major acquisitions. I would say that even in healthcare or in medical devices, I think it's pretty insulated from that. Usually, those reviews are much more stringent as it relates to technology products or technology industry or defense industry. For medical device it doesn't come into very sharp focus, but it's still a risk nonetheless.
I think the geopolitical risk currently, even with the, you know, all that's going on in the world, it's a business risk, but for right now, it's quite manageable for MicroPort.
Okay. Thank you.
Yeah. Okay. This is Martin. I take a second question about this, the cash burning or the cash flow position for this year. Give me second, right? You know that. When we look at it, because the, again, MicroPort Group listed, we are the consolidated our cash flow, you know, the picture is combined or consolidated all our groups as subsidiaries and the other business. The total, the free cash flow and outflow number, I think is around the $700 million-$800 million US dollars. Split these two parts. The first one is of course the operating and cash outflow, and that will coming from the around the $250 million-$300 million. And that is com...
Including the listed groups, such as the MedBot and CardioFlow. This is two main, you know, operating cash flow driven factors. Our remaining groups such as the orthopedics, surgical robotics, orthopedics and cardiovascular, and we also have invested the ECMO on our surgical business. That is coming from this actually for around the remaining, you know, part. But for the CapEx for this year, we will keep it around the $400 million ±, we estimated. For this CapEx, we still spread to the listing group, which we consolidate on the MPSC group. That number could be around the $200 million.
The remaining part is coming from the cardio and also orthopedics. Again, that's for cardio and orthopedics, as Johnson mentioned. For cardio business, we have already set up a U.S. facility and accelerate our you know the U.S. and overseas stent business. The CapEx will be coming from this part for cardio business. And also our orthopedics business because of the business expansion, we still consider some R&D and spending and the instruments and you know preparation. That is the CapEx earning parts. That's all. Thank you.
Okay. Good. Great. Thank you, Martin. I actually have two more questions on the line, but from the emails. Operator, do you have any questions on the line? If there is any, we can take them first.
We have a question coming to the line of Shelley Yang from Nomura. Please go ahead.
Hi. Thank you very much, management for taking my question. I just wanted to understand a bit more regarding some preferred shares issued and the options. Is it the options that require the company potentially to have to buy them back? Is there any detail on what could trigger such buyback? Redemption obligations, I think is embedded in the preferred share.
This is Martin. You mean the redemption of the preferred share of our subsidiary company financing, right?
Yeah. The Sorin CRM and by NeuroTech. It looks like it's 300 and-
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Good now.
Yeah. I know this is a share repurchase obligation. That mainly comes from our CRM business. Yes, you already see in our earnings report. This comes from our CRM business. We wish give the redemption to our-
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So that's-
Yeah. Okay. Good. Okay.
Yeah. That's for our CRM business and also for, you know, the redemption. We also have the. Let me check it. Because the CardioFlow we already it's.
Yeah. I guess I wanted to understand.
I guess I think the CRM business and NeuroTech. The NeuroTech, and the, yeah, NeuroTech is because the, for the just last year, financings, we give the, another redemption rights to these investors. I think for the CRM and then NeuroTech, this year, and maybe you know this NeuroTech business is on the road to IPO, Hong Kong IPO, though, so this year, they're listed in Hong Kong. These redemptions will be, you know, will not in our, you know, the financial statements. The CRM-
Right.
I think the next one. Yeah.
Right. The CRM one, I mean, is there a deadline by which they could be exercised?
2024. 2023, sorry. Next year.
Okay. Is there any restriction on what could trigger that?
What the trigger is for IPO. Next year, if CRM business will not have a qualified IPO, I think the first investor, Yunfeng, will have the rights to exercise the redemption rights.
Ah.
Their total investment is around $10 million. It's $10 million from maybe, I think less than $25 million.
Thank you.
I think the possibility is quite low because they invest at the valuation of CRM business is around $200 million. Right now the CRM business valuation is more than $1.1 billion. I don't think they will even next year. We feel confidence to next year to CRM IPO. Even we have a little bit delay, we don't think that the Yunfeng you know investor will exercise the redemption rights.
Understood. Thank you. NeuroTech is the same, is if there is no IPO this year, only then can it be triggered.
Yes.
Got it.
You're right.
Thank you very much.
Thank you.
Is there any more questions on the line, operator?
Pardon me. We have no further questions at this moment. Back to you.
Okay. Yeah. I actually have two questions from the email. First one is that he noticed that you've made some small investment or acquisition, first is Shanghai Huarui Bank, and the second one is a real estate in Pudong. Is it possible for you to help better understand the rationale or reasons behind that, the first. Secondly, you know, what's the updated timetable for your thing of, like, listing of your neuro business and also the EP business, if you have any. Thank you.
Okay. This is Martin. I take your first question about the Huarui Bank and the real estate in Pudong. I think for Huarui Bank, that is a quite unique opportunities for us. As you know, when MicroPort we expand business, we have so many and high value consumables to the market. We wanted to give a better how to say the financing solution to the patients and also to the hospitals. We you know the last year we have opportunity. That's the Huarui Bank. You know, if the
If you know this, the Huarui Bank is a Shanghai local bank, and it's only, you know, the Minying like they have only one Minying bank license. That's a non-state bank. They have a quite solid, we call the TMT or like a network on those business segments. We think this is a good opportunity. They offer us a board seat and with a major shareholder for their bank equities. We can have a quite strategic leverage, and, you know, the cooperation for the future.
They wanted to use the MicroPort device into their, they call them hospital chain, the scenarios and through their network. We think that is the good one for us. That also is, we believe that's the trends how to based on this, the limited resource of China's healthcare investment. We think that the commercial and the insurance and the banking could put more resources to solve the limitations. We think that's the good trial for MicroPort. The second one is for Pudong Real Estate. Why we buy this is because we think that's, you know, MicroPort, our headquarter base in Shanghai, Zhangjiang.
Right now this is a land resource or let's say the working space is quite limited and very expensive. For our long run medical device and business, we need a very secured real estate for our, you know, the NMPA approved and GMP license. We prefer that the facilities we can secure for long run. Even so last year we find an opportunity to acquire what we call the industry park in center of the Zhangjiang. Their you know I think that the expense or the price is very reasonable for us. We take this and fit for our future expansion business expansion.
Great. Thank you, Martin.
Mm-hmm.
Time is up, so I'll conclude today's call. Thanks everyone again for joining and thanks to all management. Operator, I think can we end this?
Okay. Thank you, Yolanda.
Thank you. Thank you.
Thank you, everyone.
Thank you.
Bye-bye.
Thank you, everyone. Bye-bye.
Ladies and gentlemen, that concludes our conference for today. Thank you all for your participation. You may disconnect.