4.6 CM Aortic Aneurysm

It is likely your Bicuspid valve contributed to your aneurism, I also have a BAV and had a 5.2 ascending aortic aneurysm that got repaired at your age 54, that was 5 years ago (I also had a brain aneurysm that was repaired, according to my cardiologist, who specializes in aortic diseases and BAVs, they do contribute and not necessarily only aortic). My BAV was left in place as it was highly functional and my surgeon said no artificial valve will be better than my natural and functioning valve, at some point it will deteriorate and will have to be replaced but now that my aneurysm is gone it can be done via catheter.

At 4.6 it is getting close, but you are being monitored, so you are doing the right things. Having a good cardiologist is paramount and of course a very experienced cardiothoracic surgeon. The surgeon though will see you before and maybe a couple of times after surgery, your cardiologist will be forever, so make sure you have one that really understands aneurysms and BAVs. Keep yourself healthy, exercise (as it has been said many times before do not lift heavy weights), take care of your body as that will pay dividends when and if you eventually need surgery. I am not a Dr but having a BAV and a root aneurysm may indicate that at some point something will be required, as BAVs deteriorate they may develop stenosis and regurgitation and having a root aneurysm more than likely will contribute.

As there seems to be propensity in my family for aneurysms and having a BAV with two already confirmed aneurysms, my cardiologist orders full aortic and head scans every ~4 years to make sure no new ones are appearing. It takes about 3 hours in the machine to complete, You already have 2 so may be something you may want to talk to your cardiologist about. BTW where is the second aneurysm?

I'm glad you don't feel as concerned, you seem to be dealing with everything very well. Wish you the best!!!