What is the correct cm in thoracic aorta ansersym to have surgery

A consensus document was published in September (or November) of 2022. It was published by the aortic group. It was a very extensive document. I will find you the reference. It was meaningful to us because my husband’s ascending aortic aneurysm was at 4.9 cm. We saw two CV surgeons in tbe same practice. One was “hot” to do surgery and the other (older and wiser?) said that the risks of surgery outweighed watchful waiting. This year (my husband was at 5 cm and he said surveillance at 2 or 3 yrs would be fine. We elected one year even though it means traveling almost 3000 miles round trip. My husband has no vasculitis and this aneurysm has been stable since 2021 - maybe since 2007 when it was 4.3 cm.
The first surgeon, who was eager to do surgery , did not do antegrade perfusion to keep the brain from being without oxygen. The second surgeon does do it.

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease
Circulation vol 146 nbr 24

Originally published Nov 2 2022 by ACC/AHA

Please read following studies
https://www.sciencedirect.com/science/article/pii/S0735109716336750#bib28
And this one
https://jamanetwork.com/journals/jamacardiology/fullarticle/2796795
Both studies with very huge population detail and showing risk till 6 cm is super super low

Nothing gonna happen to you at 5.5 cm. There is negligible risk till 6 cm. Enjoy your life

Doctor is saying correct. Does the patients here think the surgeon in any hospital in USA are not aware of what the risk is who operates on patients day in day our.
Risk definition is very objective, some surgeon can say 0.5 percent risk is too much And I will operate on every patient at 5 cm while for other surgeons the 1 percent risk is acceptable.
Reality is for up to 50 yr old and 5.5 cm aneurysm risk is 0.6 percent for 5 yr and will you consider surgery for that?
Read this article https://www.sciencedirect.com/science/article/pii/S0735109716336750#bib28

I am 5 ft tall and my Cardiothoracic surgeon has told me that I need the surgery now. I understand that it is NOT one single measurement that identifies who needs repair. I also have mixed connectiv tissue disorder. So to think that "nothing is going to happen to me" is not reassurring or in congruence with what the Cardithoracic surgeon has advised me..

If it is at 5cm, it is time to do something. There's a good chance it can dissect or rupture between 5 and 5.5. You need to consult with a surgeon that is experienced with this and works at a center that does lots of these. By AAA, do you mean abdominal? If so, at 5.0, EVAR may be an option.
https://my.clevelandclinic.org/health/diseases/7153-abdominal-aortic-aneurysm

Don't always think cardiothoracic surgeon are good. All hospitals have mortality of 1 to 2 percent folks in surgery for perfect healthy folks
Yes connective tissue disorder is little worrying but if you remove this from mind I am telling you , you not gonna die from aneurysm

By AAA I mean ascending aortic aneurysm

Abreviatiins can be confusing. Ascending aortic aneurysms are a type of thoracic aortic aneurysm along with aortic root, aortic arch, descending aorta and collectively called taa to minimize confusion with abdominal aortic aneurysm i.e. aaa. That said , EVAR isn't really an option with the ascending aorta. 5.0 is definitely time to meet with a good cardiovascular surgeon that specializes in these things at a high volume center. This isn't something to deal with at an average emergency room. Survival is very high at a specialty center, but not good at an average ER. I know this from experience.