Glad I found your update that Cleveland Clinic's Echo was inaccurate! I have been trying to find your post as I just went to Cleveland Clinic and had a really similar experience. I was diagnosed with a Bicuspid aortic valve and 4.2 TAA last August via TTE echo. A CTA confirmed aneurism at 4.3 (I'm assuming the .1 difference is well within the margin of error). Anyway, I went to Cleveland Clinic for a 2nd opinion about a week ago (original diagnosis confirmed). However, CC insisted on doing their own TTE echo after my appointment with the Dr. The Dr had told me in advance that TTE echos were primarily for looking at the heart NOT to measure the size of the aorta. However, when I got the results of the echo back it puts the aneurism at 4.6. The CC Dr. doesn't seem concerned, but I'm supposed to follow up with my local cardiologist and have another CTA in March (6 months after first CTA). Part of me is terrified that the aneurysm is actually growing that fast and part of me thinks the CC echo is probably just really inaccurate, which I am surprised that my local Dr.'s echo and CTA would almost be identical, yet CC could possibly be this inaccurate in their echo. Just out of curiosity is the surgeon you are meeting with at CC? If so, did you need a referral from either your local cardiologist or a CC cardiologist? Maybe we both had the same person doing our echo's or something, just very odd indeed.