ELN and Ascending tubular aorta aneurysm: In conclusion, our findings are not in disagreement with previous studies that have documented elastic fiber fragmentation or degradation and SMC death in ascending aortic aneurysms, but extend those observations in that concomitant elastin synthesis and SMC proliferation can lead to a net gain of medial tissue and an increase in cross-sectional area of the media in a significant subset of sporadic disease.