Usually, they do not operate on a 4.8cm ascending aorta, unless accompanied by a poorly functioning valve , this is because research dictates that risk of surgery is higher than risk of leaving it alone, bearing in my that there is around 2% risk in surgery, so leaving it alone is much, much lower!...
But, ofcourse, I can only tell you from what my cardiologist told me, and it's only my root thats dilated, these included Yacoub ( who ordered my scans) told me to carry on a normal life, tirone and Dr Craig miller.
I did not realize until your posts just how different size in the root really is. On page 1516 of the 2010 guidelines (linked in my other thread, see my first post above), there's a chart of average sizes. The root can be up to 1 cm larger normally, so that seems to explain very well the recommendations you've been given. 15 doctors...hard to argue with that!
But, the ascending aorta is definitely different, and the presence of BAV generally increases risk, as the last post indicated. I further agree with the last post that surgeon input is vital. It must be in the job description, I guess, cardiologists seem to be prone more often than not to recommend delaying surgery as much as possible, even sometimes against established guidelines.
Back to your comments, though, to my knowledge, the risk of postponing surgery is actually higher. This can be dissection, rupture, and/or death. For
my situation, I was told a 5% risk to do nothing vs a 2% risk for surgery. Again, all should be confirmed with a surgeon, but here's a link with more, including a yearly complication rate chart by dilation/aneurysm size:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861012/
Of course, like so many other things in all of our medical lives, there are no absolutes here either. Some aneurysms rupture below 5 cm, some hold firm even above 6 cm (pull out a ruler, and picture that!) Probably the worst part is that you can be symptom free up until rupture.