Background: Heritable thoracic aortic diseases (HTADs), including Marfan syndrome, Loeys–Dietz syndrome, vascular Ehlers–Danlos syndrome, and familial aortopathies, manifest genotype-specific patterns of aortic involvement, tissue fragility, and progression. These molecular determinants influence surgical risk, durability of repair, and likelihood of distal disease evolution. Consequently, surgical management has progressively moved from…