ascending aortic aneurism

There may be other factors that go into the decision such as location and other mitigating circumstances.

It depends on where the aneurysm is whether or not they can do it via TAVR etc. For example, the aortic root has to be open heart surgery at this point as does the ascending aorta close to it. There may be other mitigating circumstances as well.

I am going to bounce off of what moonboy said:
I was similar. Went to hospital emergency with chest pain at age 58. Knowing what happened next I don't know if I would be able to cope/survive at 78 or even 68. It was taxing for me, but 100% necessary. I was at 5.8cm when I walked in, and they were worried ("panicking" according to the hospital cardiologist). A few hours later I was at 6.5cm. I had a busted valve, and some heart failure, and both ascending and descending dissection. It was into the cardiac artery and up into my carotid (neck), and down into my legs. Remember I was in the Emergency Dept. so I had no idea about anything. Sitting on the bed was the first time I knew about it, and they didn't explain and I didn't ask. They just needed to do it, so there was no discussion. I think because I had NO other risks or health factors, they operated almost immediately.
Open Heart Surgery, cracked sternum, stopped heart, collapsed lungs, re-routing everything through machines, tubes in places they were never meant to be in (yes, that one too!), coma, ICU, recovery.
1st, please seek help from professionals - get good guidance and make informed decisions. I am not a doctor, and as you'll see I don't give medical advice, and there may be few if any doctors reading this forum. It may not have to be OHS, but that depends on YOUR OWN PERSONAL CIRCUMSTANCES - not mine, nor anyone else's.
2nd, you have all the power of the internet, unlimited information, data and resources. Use it all. But do not fixate on the negative. Look for positives and plan a course of action to solve your issues.
3rd, there is more than one way to solve your issue: explore and evaluate. Some options may be closed to you because of other factors (age/other health issues). But do not be discouraged if some options are not available because of your other issues - instead consider your issues and plan around them.
4th, if you can and if you need to, change your lifestyle to accommodate your issue/s. Think about your health and improve the positive and avoid the negative. Stick to your plan and follow advice from the medics. Test frequently and measure your success.
(and yesterday I stupidly carried 40 lbs for 50 feet - and I felt it and I know I shouldn't have done it; I was out of breath and had chest pain. I learned a lesson but it might have cost me greatly. Note to self: don't do that again!)
So < ahem> avoid risks.
And
5th, Keep in touch and let us know how you are doing. We have been through it - all types and issues, and the survivors who are still here, the ones who have had their surgery, well... we are your friends and we want to hear from you. That's why we stick around 🙂

Thank you. I will follow your advice

I first learned that something was going on when my cardiologist noted after a routine checkup and echo some years ago that he saw my aorta had enlarged slightly and we'd need to watch it. I didn't give it much of a thought and don't know what the number was then, probably 3.x. Last spring I had an echo that showed 4.1 and he scheduled me for another echo this December. I had that 2 weeks ago and the tech (same tech, same equipment as in spring) told me he was seeing 4.3-4.4. Damn. I see my cardiologist next week for my formal 6 month check and I will need to discuss my options, especially whether and when to get a CT scan for that and for my CAD. I will also ask about physical restrictions, which I am not used to having any. My BP is marginal, sometimes up around 135/80, nothing crazy. But if I need to go on BP meds, so be it. Meanwhile I feel OK and am heading down to do another hour on my indoor bike trainer.

I guess it is time for me to take this serious.... and I am glad I found the Mayo forum. I have a learned a lot here and wish everyone with this condition good luck.

I saw my cardiologist today for my periodic check and it was mostly good news. I was in error about my AA. The doc said it was 4.5 last time (I incorrectly thought it had been 4.1, but then I wasn't really paying much attention then) and 4.4 this time, within the margin of measurement variation. So while it is larger than I thought it is not getting bigger. Whew. He didn't seem worried about it at all and said we'll just keep monitoring it. No need for a CT measurement for now, no physical restrictions. Sounds good to me. Back to my regularly scheduled life, at least for now.