Why is my md suggesting genetic testing to help determine if I should wait or have surgery soon on my 4.9 thoracic aortic aneurysm?

Cause. Aortic aneurysms caused by genetic predisposition can have a much higher rupture rate and a more rapid rate of growth. These are operated on at a smaller size. Otherwise, 5- 5.5cm is the usual size to consider surgery. If there is a family history, or if the genetic testing is positive, family members should be tested.
Earlier surgery. May be indicated in patients with individuals with confirmed mutations in tgfbr2 and tgfbr1genes and/or a family history of aortic dissection with minimal aortic enlargement. This is something you and your doctor should discuss.