@howudoin....it's interesting that surgery is scheduled at 4.9cm when the general guideline is 5-5.5cm. Yes, the growth spurt you mention is notable, but would seem to warrant closer monitoring...scans... only. Do you have a clear understanding of why surgery is being done and the possible difficulties during and after? You might consider a second opinion from a high-volume aortic center like Cleveland Clinic or Mayo. It can be done quickly via the internet. Best wishes for your care journey!!