RESULTS OF OPERATIONS

Comparison of the Year Ended December 31,2021 to the Year Ended December 31, 2020





Revenue and Gross Margin:



Vycor Medical recorded revenue of $1,273,602 from the sale of its products for the year ended December 31,2021, an increase of $234,040 (or 23%) over 2020. This reflected continued recovery in the US and certain international markets following the easing of COVID-19 related issues as well as positive results from Vycor's strategy to increase penetration described under "Strategy" above. Gross margin of 90% was recorded for the year ended December 31,2021 compared to 88% in 2020.

NovaVision recorded revenues of $119,385 for the year ended December 31, 2021, an increase of $16,902 from 2020, and gross margin of 93%, compared to 94% for 2020.





Research & Development:



Research & Development expenses were $15,159 for the year ended December 31, 2021compared to $0 in 2020, reflecting early-stage product development for the Vycor division.

Selling, General and Administrative Expenses:

Selling, General and Administrative expenses decreased by $67,463 to $1,612,984 in 2020 from $1,680,447 in 2020. Included within Selling, General and Administrative Expenses are non-cash charges for share-based compensation as the result of amortizing employee and non-employee shares and options which have been issued by the Company over various periods. The charge for 2021 was $341,098, a decrease of $178,902 from $520,000 in 2020, following an amendment to the Fountainhead Consulting Agreement and the departure from the Board of Steven Girgenti and Lowell Rush. Also included within Selling, General and Administrative Expenses are Sales Commissions, which increased by $56,801 to $260,508 reflecting increased level of sales in the US.

The remaining Selling, General and Administrative expenses increased by $54,638 from $956,740 to $1,011,378. Patent costs increased by $61,396 due to Vycor division patent activity during the period and higher costs of NovaVision patents; software development and associated scientific and clinical costs related to additional development in NovaVision increased by $48,254; regulatory costs decreased by $11,407 due to the costs of international regulatory costs during the 2020 period and there was also a reduction in professional costs related to the closure of NovaVision Germany during 2020 of $19,558.

An analysis of the change in cash and non-cash G&A is shown in the table below:





                                                Cash G&A       Non-Cash G&A
Commissions                                        56,801                  -
Scientific, clinical and software development      48,254                  -
Legal, patent, audit/accounting                    46,137                  -
Other (travel/regulatory/premises)                  1,892
Board and financial                                     -           (178,902 )
Regulatory                                        (11,407 )                -
Payroll                                           (15,078 )                -
                Total change                      126,599           (178,902 )




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Interest Expense:



Interest comprises expense on the Company's debt and insurance policy financing. Related Party Interest expense for 2021 increased $2,159 following the issuance of related party notes during 2021 and 2020 to $31,841 from $29,682 for 2020. Other Interest expense for 2020 increased by $7,838 to $55,970 from $48,132 for 2020.





Other Income:



Other Income of $117,200 was recorded during the year ended December 31, 2021 from the forgiveness of Paycheck Protection Program loans

Operating loss from Discontinued Operations:

Operating loss from Discontinued Operations increased by $5,241 to $27,413 in 2021 from $22,172 in 2020; this reflected some continued costs during the first half of 2021 which, although were at a much lower level than in 2020, were not offset by revenues as they were in 2020.

Liquidity and Capital Resources





Liquidity


The following table shows cash flow and liquidity data for the years ended December 31, 2021 and December 31, 2020:





                                      December 31, 2021       December 31, 2020        $ Change
Cash                                 $            90,941     $            46,002     $     44,939
Accounts receivable, inventory and
other current assets                 $           396,470     $           417,899     $    (21,429 )
Total current liabilities            $        (3,149,997 )   $        (2,740,828 )   $   (409,169 )
Working capital                      $        (2,662,586 )   $        (2,276,927 )   $   (385,659 )
Cash provided by financing
activities                           $            61,945     $           286,552     $   (224,607 )

Operating Activities. Cash used in operating activities comprises net loss adjusted for non-cash items and the effect of changes in working capital and other activities. The net repayment of normal insurance financing should also be taken into account when considering cash used in operating activities.





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The following table shows the principal components of cash used in operating activities during the years ended December 31, 2021 and 2020, with a commentary of changes during the years and known or anticipated changes:





                                      December 31, 2021       December 31, 2020        $ Change
Net loss                             $          (435,662 )   $          (822,482 )   $    386,820

Adjustments to reconcile net loss
to cash used in operating
activities:
Amortization and depreciation of
assets                               $            68,418     $            57,895     $     10,523
Share based compensation             $           341,098     $           520,000     $   (178,902 )
Forgiveness of PPP loan              $          (117,200 )   $                 -     $   (117,200 )
Other                                $            12,360     $            12,558     $       (198 )
                                     $           304,676     $           590,453     $   (285,777 )

Net loss adjusted for non-cash
items                                $          (130,986 )   $          (232,029 )   $    101,043
Changes in working capital
Accounts receivable                  $            33,142     $           115,313     $    (82,171 )
Accounts payable and accrued
liabilities                          $            58,521     $          (182,319 )   $    240,840
Inventory                            $           (38,785 )   $            14,699     $    (53,484 )
Prepaid expenses and net insurance
financing repayments                 $            13,379     $            14,754     $     (1,375 )
Accrued interest (not paid in
cash)                                $            83,423     $            77,814     $      5,609
Changes in discontinued
operations, net                      $            (3,980 )   $           (59,071 )   $     55,091
                                     $           145,700     $           (18,810 )   $    164,510

Cash provided by (used in)
operating activities, adjusted for
net insurance repayments             $            14,714     $          (250,839 )   $    265,753

The adjustments to reconcile net loss to cash of $304,676 in the period have no impact on liquidity. The positive change in net loss adjusted for non-cash items of $101,043 was primarily due to the increase in sales as a result of recovery from the impact of COVID-19 on the Vycor division and results from the Company's strategic initiatives. At December 31, 2019 there had been an increase in accounts payable and accrued liabilities mainly due to expenditure on regulatory for the transition to a new EU Notified Body, and regulatory and testing for the VBAS development which occurred during the fourth quarter of 2019. The change in accounts payable and accrued liabilities of $240,840 between the 2021 and 2020 periods was mainly due to the settlement of these accounts during the first few months of 2021.

Additional inventory of $141,512 was purchased during the year ended December 31, 2021 as part of normal production and for marketing inventory for the VBAS AC, and the Company anticipates purchasing additional new inventory of approximately $100,000 during the next twelve months for VBAS and VBAS AC.

Investing Activities. Cash used in investing activities of continuing operations for the year ended December 31, 2021 was $38,375 compared to $62,052 in 2020, which primarily reflected completion of expenditure on the VBAS AC.

Financing Activities. During the year ended December 31, 2021 the Company received funds of $10,000 in respect of loans from Fountainhead. The Company also received a second loan of $58,600 during the period pursuant to the Paycheck Protection Program (the "PPP") under Division A, Title I of the CARES Act. Both loans received under the Paycheck Protection Program were forgiven in August 2021 and have resulted in an extinguishment of debt for $117,200, which is included in the adjustment to reconcile net loss to cash used in operating activities section on the cash flow statement.





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Liquidity and Plan of Operations, Ability to Continue as a Going Concern

The accompanying consolidated financial statements have been prepared assuming that the Company will continue as a going concern. The Company has incurred losses since its inception, including a net loss of $435,662 and $822,482 for the years ending December 31, 2021 and 2020 respectively and has not generated sufficient cash flows from operations. As at December 31, 2021 the Company had a working capital deficiency of $613,419, excluding related party liabilities of $2,049,167. As a result these conditions, among others, raise substantial doubt regarding our ability to continue as a going concern. The consolidated financial statements do not include any adjustments to reflect the possible future effects on the recoverability and classification of assets or the amounts and classification of liabilities that may result from the outcome of this uncertainty

As described earlier in this ITEM 1 "Strategy", the Company is continuing to execute on a plan to achieve revenue growth and a reduction in cash operating losses2. For Vycor Medical this plan includes: increasing market penetration in the US; increasing international growth in territories where we are not represented or under represented and continued new product development and demonstrating applicability in a broader range of pathologies. In the US the Company is focused on increasing market penetration through targeting neurosurgeons systematically, both through its distribution network and also directly by leveraging existing KOL neurosurgeon VBAS supporters to access new neurosurgeon users. The Company continues to target key international territories including Europe where it intends to drive adoption of its VBAS product through selected key KOL neurosurgeon VBAS users to identify both new potential users and also high-quality distribution partners to bolster our existing network. The Company has for some time been working to better integrate its VBAS with neuronavigation. The first phase of the modification of the existing VBAS product range was completed in September 2017 and has been well received by surgeons. The second phase involves the introduction of an optional Alignment Clip accessory that will snap onto the VBAS and allow for a neuronavigation pointer to be fully integrated with the VBAS. This VBAS AC model range has received US FDA 510(k) clearance, EU clearance and is going through the regulatory process elsewhere internationally; it is envisaged that it will be available during 2022. The Company will continue to work with neuronavigation companies to seek ways to further integrate the VBAS with neuronavigation and with other companies with complementary technologies used in neurosurgery. We will also be exploring with surgeons and focus groups additional selected development work targeted at increasing the ease and applicability of our products to additional common procedures. For NovaVision, given the company's resources, and the large size and diversity of its end markets, we believe that the most efficient way to tackle the distribution of its broad range of patient and professional products is by partnering with entities in selected geographies that have either direct access to the end users or a desire and financial wherewithal to leverage the NovaVision therapy platform, including into new areas. As a result, the Company has now closed the NovaVision German office and entered into a license agreement with HelferApp, a cognitive therapy specialist, for Germany, Austria and Switzerland, and is seeking similar partnerships in other territories with regional companies able to leverage NovaVision's clinically supported vision therapies. Management is also open to a broad range of alternatives for NovaVision as a whole, which could comprise distribution and marketing partnerships, licensing, merger or sale.

However, the Company believes it may not have sufficient cash to meet its various cash needs through March 31, 2023 unless the Company is able to obtain additional cash from the issuance of debt or equity securities. Included within the working capital deficiency above is a term note for $300,000 to EuroAmerican Investment Corp. ("EuroAmerican"), together with accrued interest of $376,897, which has a maturity date of March 31, 2023, having been extended on a number of occasions from its initial due date of June 11, 2011. At this time it is not known whether any further extension of the note beyond March 31, 2023 will be available. Fountainhead, the Company's largest shareholder, has provided working capital funding to the Company on an as-needed basis, although there is no guarantee that this will continue to be the case. The Company may consider seeking additional equity or debt funding, although there is no assurance that this would be available on acceptable terms or at all. If adequate funds are not available, the Company may have to delay or curtail development or commercialization of products, or cease some of its operations.

2 Operating Loss or Profit before Depreciation, Amortization and non-cash Stock Compensation





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Off-Balance Sheet Arrangements

As of December 31, 2021, we had no off-balance sheet arrangements.





Seasonality


Our operating results are not affected by seasonality.





Inflation


Our business and operating results are not affected in any material way by inflation.

Critical Accounting Policies and Estimates

Uses of estimates in the preparation of financial statements

The preparation of consolidated financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimated. To the extent management's estimates prove to be incorrect, financial results for future periods may be adversely affected. Significant estimates and assumptions contained in the accompanying consolidated financial statements include management's estimate of the allowance for uncollectible accounts receivable, provision for inventory obsolescence, useful life of intangible assets, and the fair values of options and warrant included in the determination of debt discounts and stock based compensation.





Revenue Recognition


On January 1, 2018, the Company adopted the new accounting standard, ASC 606, Revenue from Contracts with Customers and all the related amendments (new revenue standard) to all contracts. The adoption of the new accounting standard had no impact on company's consolidated financial statements.

Vycor Medical generates revenue from the sale of its surgical access system to hospitals and other medical professionals. Vycor Medical records revenue from product sales when obligations under the terms of a contract with customers are satisfied. Generally, this occurs with the transfer of control of the goods to customers. Vycor Medical does not provide for product returns or warranty costs.

Vycor determines revenue recognition through the following steps:





  ? Identification of the contract, or contracts, with a customer

  ? Identification of the performance obligations in the contract

  ? Determination of the transaction price

  ? Allocation of the transaction price to the performance obligations in the
    contract

  ? Recognition of revenue when Vycor satisfy a performance obligation



NovaVision generates revenues from various programs, therapy services and other sources such as software license sales. Therapy services revenues represent fees from NovaVision's vision restoration therapy software, eye movement training software, diagnostic software, clinic set up and training fees, and the professional and support services associated with the therapy. NovaVision provides vision restoration therapy directly to patients. The typical therapy program consists of NeuroEyeCoach, performed over 2-4 weeks, and six modules of Vision Restoration Therapy, performed over 6 months. A patient contract comprises set-up fees and monthly therapy fees. Set-up fees are recognized at the outset of the contract and therapy revenue is recognized ratably over the therapy period. Patient therapy is restricted to being completed by a patient within a specified time frame.

Deferred revenue results from patients paying for the therapy in advance of receiving the therapy.





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Inventory


Inventories are stated at the weighted average cost method. Net realizable value is the estimated selling price, in the ordinary course of business, less estimated costs to complete and dispose of the product. If the Company identifies excess, obsolete or unsalable items, its inventories are written down to their realizable value in the period in which the impairment is first identified. The provision for inventory for the years ended December 31, 2021 and 2020 was $12,360 and $12,558, respectively. Shipping and handling costs incurred for inventory purchases and product shipments are recorded in cost of sales.





Discontinued Operations



In accordance with ASU No. 2014-08, Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity, a disposal of a component of an entity or a group of components of an entity is required to be reported as discontinued operations if the disposal represents a strategic shift that has (or will have) a major effect on an entity's operations and financial results when the components of an entity meets the criteria in paragraph 205-20-45-1E to be classified as held for sale. When all of the criteria to be classified as held for sale are met, including management, having the authority to approve the action, commits to a plan to sell the entity, the major current assets, other assets, current liabilities, and noncurrent liabilities shall be reported as components of total assets and liabilities separate from those balances of the continuing operations. At the same time, the results of all discontinued operations (which we presented as operations to be disposed and operations disposed), less applicable income taxes (benefit), shall be reported as components of net income (loss) separate from the net income (loss) of continuing operations in accordance with ASC 205-20-45.





Contractual Obligations


As a "smaller reporting company" as defined by Item 10 of Regulation S-K, the Company is not required to provide this information.

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