Navigating an unexpected double diagnosis: Meet Marie Baffa

Surprises can be pleasant or unsettling. Marie and Robert Baffa experienced the second kind, when Marie received an unexpected double diagnosis of severe aortic stenosis and lung cancer. With help from Stony Brook Medicine, the Baffas navigated all the twists and turns of Marie’s journey back to health.

Severe Aortic Stenosis
Marie's aortic valve, the valve separating the heart from the body's main blood vessel, was deteriorating because of stenosis (narrowing). Her interventional cardiologist, Daniel Montellese, MD, examined Marie and referred her to cardiothoracic surgeon Henry Tannous, MD, Co-Director, Stony Brook University Heart Institute, and Chief, Cardiothoracic Surgery.

TAVR: A lifesaving option for people with severe aortic stenosis
Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment for people with severe aortic stenosis (narrowing); it is now FDA-approved for those of all surgical risk categories: low-, moderate- and high-risk. TAVR is used to replace the aortic valve but does not require removing the damaged valve, which eliminates the need for invasive open-heart surgery. Side effects are minimized, and the procedure is safe for those who are at high risk of complications from surgery. For many, TAVR offers a lifesaving option, where none existed for them before. Stony Brook Heart Institute was among the first in the country to advance TAVR and offer it to low-risk patients, benefiting the lives of hundreds of cardiac patients in Suffolk County.

 
Marie, Robert and their dog, Puzzle, walking on the beach near their Port Jefferson home.

Transcatheter Aortic Valve Replacement (TAVR) for Low-Risk Patients
Fortunately for Marie, Stony Brook Medicine was part of a study of the TAVR (transcatheter aortic valve replacement) procedure for low-risk patients. At the time of Marie’s procedure, this minimally invasive option was typically only used for patients who were considered high risk for traditional open-heart surgery because they are too ill to tolerate it. Marie and Robert found out that Stony Brook University Heart Institute, which has extensive experience performing TAVR, was one of only six facilities in the nation actively enrolling low-risk surgical patients as part of the “Low-Risk TAVR 2.0” trial.

A Routine Scan Discovers a Type of Lung Cancer
Next came news they weren’t expecting. A routine preoperative scan showed something embedded in Marie’s right lung. Further investigation revealed it was a malignant carcinoid tumor, a type of lung cancer. “It was quite a surprise, and was upsetting,” Marie recalled. Robert agreed, “We were certainly taken aback by it. We had our faith and the strong support of our children, Claudia and Brett, and our grandchildren, Gabriela and Xavier, every step of the way.”

At Stony Brook, Valve Clinic Coordinator Susan Callahan, NP, became their biggest advocate and helped the Baffas navigate Marie’s enrollment in the TAVR low-risk clinical trial and her two procedures.

Dr. Montellese, Dr. Puja Parikh and Dr. Tannous (“our dream team,” Robert and Marie call them) performed Marie’s TAVR surgery together. One day later, she was discharged home. Another day after that, “We were walking on the beach and feeling exhilarated,” Robert said. “It is a miracle procedure.”

Heart-Healthy and Cancer-Free
Six weeks later, with Marie’s new aortic valve in place, it was time to tackle the lung cancer. Dr. Tannous performed a video-assisted thorascopic surgery lobectomy, removing 40 percent of Marie’s right lung. The surgery went well, with biopsied lymph nodes coming back negative. “The combination of Marie’s aortic valve replacement, plus the unanticipated lung cancer diagnosis, was very overwhelming for her at first, but she pushed through her ordeal,” Dr. Tannous said. “She had a speedy recovery and is now heart-healthy and cancer-free.”

“Because we are an academic medical center, Stony Brook Medicine can enroll patients in the newest clinical trials,” he continued. “This allowed Marie to be part of a study of TAVR for low-risk patients. It was the right surgical option for her.”

Recovering Well
Today Marie is recovering well. “I feel very lucky and very blessed,” she said. She and Robert are back to walking on the beach near their Port Jefferson home. “The beach is our daily routine forever,” said Robert — the couple met on Sand Street beach in Stony Brook when they were teenagers. Their dog, Puzzle, likes to join them in enjoying the salt air and seaside breezes.

During Marie’s medical challenges, she and Robert prepared themselves for what they had to face. Marie is a Reiki healing practitioner, so she turned to Reiki and acupuncture for physical and emotional healing before the surgeries. And they say being able to talk comfortably with Dr. Tannous gave them confidence to go ahead with Marie’s treatment.

“We were impressed by his incredibly gentle manner and his patience,” Robert said. “I had 50 questions, and then 50 questions beyond that, and he sat and explained everything.”

Marie said, “He’s a wonderful, wonderful surgeon. He’s such a kind man, and anything he can do to make whatever you’re going through a bit easier, he really thinks about that. I’m glad I know him.”

 

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