I agree with the other responders who say that given your aneurysm size and other medical issues, you should get a referral to, rather than just a second opinion from, a high volume aortic center. I'm in CA as well...we're lucky that we have several very good high volume aortic centers...with this type of surgery, it's especially important to have your surgery done by a surgeon who specializes/does many of these surgeries, on a regular basis. Are you in Southern or Northern CA? I'm in the Bay Area, and while my aneurysm is still small--around 4cm...I've scheduled an appointment with Stanford's Aortic Disease clinic. They're planning to do genetic testing, and I'll see a cardiologist with a specialization in aortic issues. Due to my dialation still being on the smaller size, I am not scheduled with the cardiothoracic surgeon yet...but I've heard from several people that at Stanford, Dr. Fischbein is excellent. I chose Stanford over UCSF because when I did a bit of research it looked to me like Stanford's results for thoracic aortic aneurysms were a bit better than UCSF's were...though I think UCSF has a good program as well.