Should my father have surgery for his aneurysm? my dad is 71 years old and a long time smoker. he recently had an aneurysm, but the doctors said surgery is not recommended. the size of the aneurysm is 4.6 centimeters. is surgery really too risky?

Whether : Whether or not to surgically repair an asymptomatic aortic aneurysm depends on weighing the risk of surgery versus the risk of aneurysm tear or rupture. When risk of rupture exceeds risk of surgery, it makes sense to operate. But, if surgical risk is higher than risk of rupture then operating is not likely to help the patient. For most patients, the threshold to operate is 5.5 centimeters and so this is the recommendation from professional societies like the american college of cardiology and the american heart association. Surgery is also recommended if the aneurysm is associated with pain. It is critical that your father quit smoking and maintain good blood pressure and cholesterol so as to minimize his risk for a dangerous complication.

No: Depending on his other medical problems, the surgery may be more of a risk then a benefit to him. He needs to stop smoking, that is the best thing he can do for himself.

Close monitoring: Indications for surgical intervention are: symptomatic, larger than 5.5 cm, growth rate of greater than 0.5 cm in 6 months. It sounds like he does not meet the criteria at this time but close monitoring is required. Endovascular repairis usually possible, once repair is indicated search for surgeon with endovascular experience.