Treatment In Thoracic Aortic Aneurysm: Surgery versus Surveillance


The primary objective of the trial is to compare the composite outcome of the all-cause mortality and incidence of acute aortic events between surveillance and elective ascending aortic surgery for patients with degenerative or bicuspid valve-related ascending aortic aneurysm after 2 years of follow up. The hypothesis is that the early surgery group will have a significantly lower all-cause mortality and incidence of acute aortic events at 2 years of follow-up compared to the surveillance group. The result of this trial will provide evidence-based guidance in the appropriate management of ascending aortic aneurysm based on the size criteria, and establish a large database for future investigations.


  • Patients between the age of 18 and 79 inclusive.
  • Ascending aortic aneurysm between 5.0cm and 5.4cm in maximal diameter as measured by CT with contrast.
  • Patients with ascending aortic aneurysm with a diameter of 4.5 cm - 4.9 cm will be observed with serial CT, and will be considered for enrollment into the trial once the aneurysm reaches 5.0 cm.