It's my understanding that insurance doesn't want to cover surgery until you reach 5.0, unless something else is going on. I also asked my cardiologist about getting surgery earlier rather than later. I'm nearly 80 and don't relish having this major surgery when I'm even older. He said I should wait until the benefits outweigh the risks. This is a serious operation. Given what I know now about the long recovery for most patients, especially older ones, I may not have surgery at all. I'm at 4.2 and will have another CT scan in July. Fingers crossed it's still the same. I've never been keen on exercise but I try to walk most days, weather permitting. I've given up on gyms. Those of you who depend on exercise to stay sane and feel healthy--like my son and daughter--always amaze me. I guess it's how some folks feel about opera. You really like that? Anyway, common sense tells me that overdoing the exercise is asking for trouble. Move it or lose it, but don't push so hard you blow a gasket.

Mine was diagnosed at 4.0 almost 4 years ago and then went to 4.2 in a year. Now steady at 4.5 the last year and a half. Based on information from my local cardiologist and also from the head of cardiothorasic surgery at a university hospital who also reviews my scans, surgery is recommended at 5.0 cm (unless they see a rapid increase in readings). They explained to me that surgery is major and high risk, around 5% fatality rate, but depends on the hospital. Not having surgery before 5% the risk is down to well below 1%. They also told me that people who manage it (no heavy lifting, no strenuous exercise, keeping blood pressure low etc) have a low risk and as one of them said "you would go from something else totally unrelated".