Holding pattern. Long story short......
diameter of aorta at the root should be 3.2ish CM. Mine was originally measured at 4.2CM. The risk of surgery vs. the risk of not doing surgery (valve sparing aortic root replacement) becomes about equal at 5.0CM. The risk of not having surgery becomes greater than the risk of having surgery at about 5.5CM.
According to the docs in KC mine has grown to 5.3CM (not my **** you jackalopes its still much smaller than that). The result is I switched from once a year monitoring to every 6 months and prep for surgery. I've been in that pattern for about 2 years (where I could have surgery at any time but have been putting it off....knowing my days are numbered.).
I finally decided to bite the bullet and take the plunge. I want the best and the best IMHO is the Cleveland Clinic. The docs in KC claim they can do the surgery but never have (its not common and is pretty tricky/risky). The folks in cleveland have done hundreds of them in the last decade or so.
I went to the CC a few months ago (never did find the steamer) and went through a couple days of testing.
They (CC) measured it at 4.8CM. A full .5 CM less than the folks in KC.... a margin of error equal to having surgery or not.
I've since been trying to resolve this.
Bottom line.... Cleveland is right (I think better images and more experience), and I am back to once a year monitoring at the Cleveland Clinic rather than KC.
There is near 100% certainty I need the surgery and it will continue to grow, but it could be next year or it could be in 10 years.