I am sorry to hear about your brother. I survived a complete dissection in 2015 at 50 years old. If I had known then what I know now, I would elect for surgery 100 times out of 100. The odds of surviving a sudden complete dissection are abysmal. My unknown, sudden and unplanned dissection was a personal, medical, and financial disaster. Be sure to join the Ritter Aortic Study at the University of Texas - Houston. They will gather your DNA as well as any willing family members to help understand what genetic predispositions there are. I would not wait for surgery. It is always better to have planned surgery: first thing in the morning, all the docs and nurses ready to go, all the supplies at hand, plenty of blood product, your financial affairs in order, your family properly briefed, in a great cardiac surgical center, and most of all--with a clear a plan for exactly what's wrong and how to fix it. It's the difference between filling up with gasoline before you set out into the desert vs. just hoping to find a gas station that may never appear. Again, I am sorry to hear about your brother. Peace.