How do you deal with an ascending aortic aneurysm? To operate or not to operate?

Operate. If it is truly an ascending aneurysm, it is life threatening and needs an operation. Type b or descending aneurysms in the thorax can many times be managed with blood pressure control but not type a. Type a can cause heart attack and strokes or rupture.
Aortic Aneurysms. Ascending aortic aneurysms require an operation if they have reached a certain size, usually around 5.5 cm, or if they have caused leaking of the aortic valve. Consult with a cardiac surgeon to discuss further. Dr. Sinha is discussing aortic dissections which require emergency surgery because of an extremely high mortality (classically 1% per hour) when classified as type a.