Taiwan Association of Thoracic and Cardiovascular Surgery (TATCS) Position Statement: Surgeon's Role in the Present Era of Isolated Severe Aortic Stenosis Patient Management.

Background: Aortic stenosis (AS) is the most common primary valvular disease, with a high prevalence (12.4%) among older patients aged ≥ 75 years. Early intervention for AS is critical, as untreated moderate and severe AS are associated with high mortality rates. Evolving patient demographics and procedural trends in surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) call for a structured framework of favorable treatment options for AS comorbidities and cardiac anatomic variants. Methods: The Taiwan Association of Thoracic and Cardiovascular Surgery held multiple meetings in 2024-2025 for local experts to examine the latest evidence and current trends and to facilitate discussion on the management of isolated severe AS in Taiwan. Results: Patient age, comorbidities, and unique cardiac structure frequently involve complex situations requiring treatment beyond SAVR or TAVI in AS management, emphasizing the need for thorough patient evaluation, accurate valvular imaging, and comprehensive patient-centered care with a multi-disciplinary heart team. Conclusions: Treatment options for individual patients must be carefully considered regarding their risk factors, anticipated life expectancy, and baseline health status. The cardiac surgeon provides valuable insights into surgical and alternative treatment methods tailored to individual patient conditions, and plays a critical role in the shared decision-making process in AS management.