Severe TAA increases the probability of cardiovascular mortality. Given the low event rate of aortic death (0.2%) this is not explained solely by increased dissection risk. Interestingly, there is a doubling of CVD mortality likelihood when moving from the proximal to the distal AscAo. These results suggest that patients with severe ascending aortic dilatation may be at higher CVD risk compared with those with aortic root aneurysms, identifying new considerations for risk stratification and surgical management.