Not only would I get a second opinion, I would fire this doctor. Sounds like guidelines from the 1980s or 90s. You need cardiologists and surgeons that specialize in this sort of thing. I figured out that the average doctors in Tallahassee were clueless about these things and went to Mayo in Jacksonville last July. Turns out I had several things going on and the aortic root and ascending aorta aneurysms were 4th on the list. By Sep 6th, I had 3 catheter procedures. On Sep 10th, I had open heart surgery resect a right coronary artery aneurysm, ligate a complex coronary fistula from the RCA and LAD to the pulmonary artery and a double bypass on the LAD. After all that, I ended up with a Bental procedure that day to replace the root, valve and most of the ascending aorta. It was 4.8 cm at the root but disintegrated when they were about to close me up. Fortunately we had discussed 3 contingency plans and the surgeon was ready for that. It ended up being 14 hours of surgery. I wasted from Oct 2023 to July 2024 with the local cardiologist blowing me off. Turns out I wouldn't have made it to Christmas with about 4 ways to die. I have posted more in depth discussions about my odyssey in other threads.