Funny that you resurrected this question, because I just had testing done again and found out some things... about 4 months ago I had another Echocardiogram done and the results said that my ascending aorta increased from 3.9cm (originally tested in 2021) to 4.3cm, so about 2 months ago I went to cardiologist/heart specialist for followup. The heart specialist studied my results and came back to the conclusion that I have a congenital heart defect (bicuspid aortic valve) which is contributing to the ascending aortic aneurysm. Heart specialist basically said that I need to prepare for open heart surgery due to the rapid expansion of the ascending aortic valve. So to get a clearer picture the Heart specialist ordered me to get a Chest CT scan w/ contrast which would be more accurate than echo. I had CT scan about a month ago and my results actually showed that Ascending Aorta didn't increase (measured approximately the same/comparable to original 3.9. So the Heart Specialist said everything is appearing stable right now and just need to monitor as we move forward. The fact that I do have a bicuspid aortic valve (congenital heart defect) it is almost inevitable that I will have to have heart surgery at some point in the future. In my case, the heart specialist didn't tell me I need to stop TRT, nor did he indicate that TRT contributed to anything negative. Hope this helps...