New perspectives in the management of adults with congenital heart disease: insights from the 2025 ACHD Congress

The population of adult patients with congenital heart disease (ACHD) is rapidly growing thanks to advances in diagnostics and therapeutics. However, these patients now encounter new clinical and healthcare challenges. The '<i>New perspectives in ACHD management'</i> session at the ACHD 2025 Congress highlighted the key areas of innovation aimed at improving prognosis and quality of life. The aging ACHD population places substantial demands on geriatric medicine, with significant implications for the healthcare system. Similarly, the increasing arrhythmic burden, in particular atrial fibrillation, requires specific preventive and therapeutic strategies, including ablation procedures tailored to the anatomical peculiarities of ACHD patients. Pulmonary hypertension is a major contributor to morbidity and mortality in ACHD, requiring precision medicine approaches, dedicated risk stratification, and multidisciplinary approach. A central role is played by adequate prevention of acquired cardiovascular diseases, whose incidence is higher and occur earlier than in the general population. Specific risk stratification tools and an integrated approach of lifestyle modification and innovative pharmacological therapy are necessary. Telemedicine offers new opportunities for remote monitoring, access to specialized expertise, and comprehensive support, particularly for frail patients or those living in remote areas. Lastly, emerging technologies such as 3D printing, virtual reality, computational modelling, and artificial intelligence are transforming treatment planning and enabling personalized care. A multidisciplinary and technologically advanced approach is essential for shifting the focus from merely prolonging survival to truly improving the quality of life of ACHD patients.