The natural history of an ascending thoracic aortic aneurysm is expansion resulting from hemodynamic factors acting in accordance to LaPlace’s Law and progressive arterial wall weakening. An aneurysmal expansion to 6 cm is associated with a 14.1% per year risk of rupture, dissection or death. However, the presence, and subsequent expansion, of the aneurysm rarely produces symptoms until catastrophic complications ensue. Once the complications are diagnosed, 24.8% of patients with a Stanford type A dissection die prior to hospital presentation, 14.5% die within 6 hours of hospital arrival, 28.9% within 24 hours, and 56.6% within 30 days. Although current guidelines suggest surgical repair when the aortic diameter reaches 4.5-5.0 cm, aortic complications can occur at even smaller diameters. Hence, early diagnosis of those aneurysms with a subsequent increased risk of a calamitous complication, regardless of diameter, would be of considerable clinical benefit.