Image of the Week: What is the threshold for surgical intervention?

A 55-year-old woman with a history of hypertension presents for a routine pre-employment checkup. She is a smoker with a 20-pack-year history and occasionally feels short of breath but is otherwise in good health. On physical examination, a diastolic murmur is heard and she is referred to a cardiologist. Echocardiogram reveals a dilated aortic root, and a CT demonstrates the ...