Thoracic Aortic Aneurysm

Makes sense, descending would be easier

echo is the more accurate of the two ? Well that odd . CT scan at 5cm and Echo at 4.3 is a big difference. The doctor said are you willing to take survery on doing the surgery before 5.5 ?
Well ok , I don't see the logic , If there is a problem at 5. it has to be fixed

CT scans are typically more accurate than echocardiograms in measuring thoracic aortic aneurysms.

In your case, the CT scan showed a 5cm size, while the Echo measured it at 4.3cm, with a 0.7cm difference over 2 months.

Expert
This discrepancy can be due to CT scans providing detailed cross-sectional views and being less operator-dependent, while Echo relies on sound waves and operator skills.

3 pros said echo don't count , its the CT scan you go by, which is 5cm
So maybe a year or 2 before they fix it at 5.5 , Standard stuff by surgeons

I guess you should learn to say Thoracic Aortic Aneurysm properly in case there's a test

I still hate my dentist who gave me these dentures , i hope that's not the case on the heart surgeon

I'm not feeling well informed from the San Fran cardio dept VA hospital
so I'm thinking about sending the doctor a stripper and a note :Call me

Primarily because the TEVAR type of "band aid" has not been well tested or successfully tested in ascending thoracic aneurysms. There is more pressure above the heart than below the heart (descending aortic aneurysm), which makes this type of TEVAR surgery more risky for the longer term --- AT THIS TIME. I suspect that this will change over time.

Fix at 5.0 cm or 5.5 cm? This is controversial among the experts.
This should be an individual decision. My understanding is that a female patient, who smokes, should probably have the surgery below 5.0 cm. The guideline was lowered from 5.5 to 5.0 at a conference in Fall 2022. Right after that a very well done study from Kaiser came out that suggested patients that are well managed (BP controlled, etc.) might be better off to wait until the aneurysm is 5.5.
This is not an easy surgery. Morbidity and mortality risks are NOT low. These statistics differ widely by centers. A patient would be well advised to have this surgery done at a center where they do a high volume of this procedure. Typically, centers that also do a reasonable volume of heart transplants may be a good choice/
There is also literature that indicates cooling the body is not enough. Mortality and neurological morbidity are significantly lower if the surgeon uses either antegrade or retrogade perfusion to the brain during surgery - and moderately cools the body.

I'm not sure if I feel better or worse on you stats
The regular civilian doctor said San fran Vet hospitals have great surgeons
so don't worry on a 2nd opinion

Makes sense