Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: Thanks for the query As you know there are no clear indications for surgery of thoracic aneursm,but it is considered that those sized >5cm and those growing for more than 1cm a year should be repaired. Also, symptomatic aneurism and aortal dissection should be managed as well. Your aneurism will grow for sure.but it is hard to predict its dynamics. Considering your case,usually if there is no grow in last 3 years then it can probably grow just 0.3-0.5mm per year and it means that it would reach 5cm in 10-15 years. This is long period and you shouldnt be worried about such far future. Even if it reach 5cm,surgery may still not be necessary. Surgical procedure is complex and have certain risks,but today results are very good. But as I said you should not think of it at this point. In every case,if you dont have symptoms and there is no size change, this is very good sign.Just regulate your blood pressure and body weight and have frequent follow ups. Wish you good health. Feel free to ask. Regards

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Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: This is not something that should worry you,since chances are very low. Generally,when aortal wall become weaker,it become thinner too and then it widen. So size is correlating with risk of rupture pretty well. Other risk factors are obesity, connective tissue disorders, hypertension and aortosclerosis. If there is risk of rupture or dissection you would start to feel certain symptoms several weeks or days before. So if you do frequent follow up and report any new sign or symptoms, I am sure that nothing can surprise you. There is a possibility of endovascular stent placement in some institution,but 4.4 is still small aneurism and I dont see a reason for any invasive procedures at this point.

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