I hope the cardiologist your going to see next week will give you a valid information. Based on what I see, I don't think you have to worry that much. I am much younger than you (43 years old) with the same size of ascending aorta. Based on the what I know the older you get the bigger the size of Aorta. What that mean is that, given the same size, mine is worse as compare to yours. To compare the previous size with the current one, you have to measure with the same technology. Don't think, the size grew by 0.2 cm after last year. This may be due to margin of error due to the two technology. Unless, you have observable symptom in you daily health such as chest pain, tiredness OR other underlying health conditions, don't worry that much. Ask the Cardiologist about the root of Ascending Aorta from the Echo, that is the key to make surgery decision due to the risk. Since you have tri-cuspid aortic valve, yours is far from surgery recommendation. I think for tricuspid, the guideline is 5.5 cm based on The Society of Thoracic Surgeons. For bicuspid it is 5 cm. It may take the next 10 years for you to get to the 5.5 cm recommendation. Update me what the cardiologist said next week. Please don't worry!