Update on conflicting surgery recommendations

Quick recap. I am 57. My TAA was discovered in 2021. I think it was 4.1cm at the time. I have been seeing Dr. Joseph Coselli at Baylor Medical in Houston since and I have a CT done annually. This March the CT relieved my TAA was at ~4.8cm depending on who is doing the measuring. As I left Dr. Coselli's office he gave my wife a wink and said "he will be fine." I won't go into the reasons why but I have gotten two second opinions in the last six months. One from Dr. Joseph DeRose at Montefiore Medical in the Bronx. He looked at the CT images and said if I were his patient it would not be up for discussion, he would insist I have surgery. He cited recent research that shows the length of the aneurysm is a better predictor of dissection than diameter (if anyone is interested send me your email and I will be happy to share it with you). My length was 11.2-11.3 cm. Dr. DeRose and this newer research is suggesting that 5.5cm in diameter should not be the magical number when it is time for surgery. Since I had two conflicting recommendations I went for a third from Dr. Leonard Lee at RWJBarnabas in NJ (he repaired a TAA for someone I know a year ago). Dr. Lee 's recommendation was to wait until the aneurysm grew >5.0cm. So two of three are saying to hold off, but the two that are recommending that I wait haven't said anything about the length and are not concerned about the length even after I pressed them on it. My wife and I are scheduled to travel to Italy in September and to help us make the decision I had a CT Angiogram last week. The person who read the images from Baylor Medical said there has been minimal growth from when I had a CT with contrast in March 2024. They read my aneurysm at 4.5cm. So frustrating how multiple people keep reading my images and give me different sizes. Now I am waiting on Dr. Coselli and Dr. DeRose who both have copies of my images to get back from vacation to tell me how they interpret my aneurysm. Here is the real kicker. The logical side of my brain is aware of the risks of walking around with this thing and that I am taking a chance every day but the emotional side of my brain is scared to go ahead with the surgery. The person I mentioned above who had their TAA repaired a year ago, his brother had the same surgery and died months after from a blood clot. That's what I am focusing on. Not the person I know who survived, recovered and is living a healthy life. Why? I almost wish this thing would grow more so all the doctors tell me its time to have surgery. No question. Then I would have no choice.