Structural heart care in Asia–Pacific is entering a decisive transition, but not along a single path. While some markets now operate transcatheter-first models supported by mature data and reimbursement, others remain predominantly surgical due to access, funding, and infrastructure constraints. This Clearstate report examines how valve replacement therapies are evolving across key APAC markets, and why global assumptions increasingly fail at local level. For MedTech leaders, the implication is clear: future growth will be shaped by how effectively technology strategy aligns with market-specific realities — from pricing and clinical capability to ecosystem readiness.