February 24, 2026: ACHD Guideline in Focus—From Survival to Stewardship | JACC This Week

In this episode of JACC This Week, Dr. Carolyn Lam and Dr. Harlan Krumholz spotlight the 2025 Adult Congenital Heart Disease (ACHD) Guidelines and explore what they signal for the future of cardiovascular care. Framed by Dr. Krumholz's Editor's Page, "From Survival to Stewardship," this discussion highlights a broader transformation in cardiology: advances that once turned fatal conditions into survivable ones now demand lifelong, structured, and hyper-specialized care. The conversation examines how ACHD exemplifies the shift from episodic survival to coordinated stewardship—where surveillance, systems design, and scalable expertise are essential. The episode also reviews key updates from the guidelines, including risk-based classification, lifelong monitoring, ACHD center collaboration, and global and early-career perspectives. Additional highlights from the issue include cardiac screening in the young, cardio-renal trial insights from CONFIDENCE, wildfire-related cardiovascular risk, and emerging cardiometabolic intersections. This mini-spotlight issue challenges clinicians to rethink how specialized cardiovascular care can be delivered effectively at scale.