When to replace the ascending aorta?

Ascending aortic aneurysm, while usually detected incidentally, is a serious condition that requires close monitoring and timely surgical follow up. Management of patients with thoracic aortic aneurysms (TAA) is optimally performed in a multidisciplinary manner that prevents or delays the need for surgical intervention. Patients with aneurysmal degeneration should be followed in a medical aortic clinic that manages all risk factors in an effort to delay or prevent the need for replacement of the ascending aorta. Symptoms, aortic size, growth rate, and genetic/familial factors are taken into account to develop a treatment plan specific to each patient that is in line with the most recent national guidelines. This article provides an evidence-based overview and key recommendations for intervention on the ascending aorta.