Patient Story
Stephen’s Critical Pivot
Adapting Cardiac Care in Real Time
It was supposed to be a quick, two-day trip for a straightforward procedure. That’s what Stephen Cloutier and his wife, Eliza Duade, had packed for when they left their home in New Hampshire and drove three hours to what is now Boston Medical Center – Brighton.
But once Stephen was under anesthesia and the care team began their evaluation, the plan needed to change.
“Everyone was in the operating room, ready to begin,” explains Chief of Cardiac Surgery Stanley Tam, MD. “But on closer inspection, we saw that Stephen had a serious issue with his aorta. The original procedure was no longer a safe or effective option.”
Instead of the less-invasive procedure they had expected, Stephen would now need open-heart surgery to replace a valve and repair an aneurysm. What was supposed to be a 48-hour stay quickly became a weeklong hospitalization.
A Surgery 30 Years in the Making
Thirty years ago, a kidney stone sent Stephen to the emergency room. While the stone passed, doctors noticed a heart murmur and urged him to follow up with a cardiologist. That visit led Stephen to Adam Cerel, MD, who remains his cardiologist today.
Further testing revealed the cause of the murmur: Stephen had a bicuspid aortic valve, a congenital heart defect where the valve has just two cusps instead of the usual three. Over time, it can place additional strain on the heart and affect how the valve opens and closes. Dr. Cerel’s diagnosis essentially started a timer: in 30 years, they would need to replace that valve completely.
For years, Stephen returned for annual checkups to track changes and monitor his valve. Nearly three decades later, as predicted, the numbers reached a dangerous level. Stephen would have preferred to power through, keeping up his active routine of running and pickleball. But his symptoms progressed to the point where the predicted surgery was necessary.
The next question became: who would do the procedure?
The Only Recommendation
Instead of open-heart surgery for a full valve replacement, Stephen and Eliza planned to proceed with the less invasive transcatheter aortic valve replacement (TAVR) procedure, which would allow for a shorter hospital stay and recovery. At the time, this was an available option.
“I was afraid of the operation,” Stephen admits. “Dr. Tam is the only cardiac surgeon that Dr. Cerel would honestly recommend. He said, ‘You have to see Dr. Tam—he’s the best.’ He actually said ‘the best.’”
As chief of cardiac surgery at BMC Brighton, Dr. Tam leads a program recognized for its quality of care. BMC Brighton has been rated high-performing in aortic valve surgery and heart bypass surgery by U.S. News & World Report, earned the American Heart Association’s Gold Quality Achievement Award, and received a top three-star rating in Cardiac Surgery from the Society of Thoracic Surgeons. That depth of expertise and national recognition is exactly why Dr. Cerel insisted it should be Dr. Tam.
On the day of the procedure, Stephen and Eliza made the three-hour drive to Boston, expecting to return to New Hampshire two days later.
“I could not have been in more capable and caring hands,” Stephen writes in a letter to Dr. Tam, "From the bottom of my newly repaired heart, thank you..."
When the Plan Changed
Dr. Tam and his team had begun the scheduled TAVR procedure when they realized they needed to change course. After further evaluation, they discovered that Stephen required an entire aortic valve replacement and the repair of an ascending aortic aneurysm.
Because her husband was still under anesthesia, the team first shared the update with Eliza.
“Stephen was going to wake up soon, and they needed me to help convince him to have the new operation,” says Eliza. “They knew he would want to go home and think about it.”
Stephen agrees that this was his first instinct. The full replacement would require open-heart surgery—a far more complex and invasive procedure than the family had prepared for, with greater risks and a longer recovery time. Stephen wanted time to evaluate alternative options. But the reality was that this was an emergency—his valve was no longer opening—and this was his only option.
To convey the seriousness of the moment, Dr. Tam spoke plainly with his patient, “If you go home, you’re likely not going to live very long.”
The Procedure Itself
Dr. Tam’s directness and honesty likely saved Stephen’s life.
Though Stephen initially said no, Stephen agreed to the procedure. He recalls feeling very calm once he made the decision to stay.
Anesthesia was administered, and Dr. Tam and his team began the operation, keeping Eliza informed throughout. Even with the unexpected change in plan, the surgery was a success.
Dr. Tam replaced Stephen’s aortic valve and repaired his ascending aortic aneurysm, and the procedure was completed without complications.
Seven Days, Side by Side
Because Stephen and Eliza lived three hours away, Dr. Tam made a decision that meant everything to them: Eliza could stay with Stephen in his room throughout his hospitalization, unless he was in intensive care.
She stayed all seven days.
Those days were filled with card games, quiet walks through the hallways, and conversations with every nurse, doctor, and hospital team member. In the morning and evening, Stephen and Eliza would walk together and look out the window from the end of their floor.
“You could see the hospital billboard,” Eliza remembers. “The town is all around, and it leads into the hills behind it. I just loved that view. It became one of our core memories.”
An artist by training, Eliza began sketching that landscape during their stay. The drawing would be turned into a card and sent, alongside a deeply personal thank-you card, to the care team—both of which are now framed on Dr. Tam’s desk.
Their Gratitude and Life After Surgery
Today, Stephen is back to his active life—playing pickleball, staying involved in church and his community, and enjoying time with Eliza—without the physical limitations he once had.
“For years and years, my heartbeat sounded different because it leaked so badly,” Stephen says. “Now I have a normal heartbeat. I’m still not used to it. It wakes me up because it’s so loud. It’s a funny side effect.”
For Stephen and Eliza, the experience at BMC Brighton left a lasting impression—not just because of the outcome, but because of the people.
As Stephen wrote in his letter to Dr. Tam, “I could not have been in more capable and caring hands. Everyone with whom I interacted was both competent and caring. From the bottom of my newly repaired heart, thank you for being part of the team that ultimately saved my life. You have my eternal gratitude.”
Stephen’s experience reflects the level of care that Dr. Tam and his team strive to provide every patient. When plans needed to change, the care team at Boston Medical Center – Brighton adapted quickly, keeping Stephen and Eliza informed, supported, and at the center of every decision.
Find Expert Care, from Evaluation to Treatment to Recovery
At BMC Brighton’s Center for Advanced Cardiac Surgery, each surgery is performed by a specially trained cardiac team that provides comprehensive care before, during, and after the procedure. We have been recognized by U.S. News & World Report for our high-performing aortic valve and heart bypass surgeries.