Joshua Servantez takes after his father, Craig. He has already learned to finish concrete and someday hopes to take over Servantez & Sons, the family contracting firm in Mason City. He is a middle-school athlete with interests similar to Craig’s in wrestling and football. Joshua also was born with an atrial septal defect (ASD)–a hole in the wall between the collecting chambers of his heart–just like his father’s.

It was discovered last year, when he was 12. Joshua went in for a sports physical and his pediatrician heard a heart murmur: irregular heart sounds–a whooshing, rasping noise, in between the typical lubb-dubb heartbeat–that could have been caused by any number of different conditions. Children’s Hospital of Iowa, a component of University of Iowa Hospitals and Clinics, runs a pediatric cardiology Child Health Specialty Clinic in Mason City, and it was there that ultrasounds confirmed Joshua’s diagnosis.

Five years earlier, Craig had undergone open-heart surgery to repair his ASD. He was 38, suffering constant chest pains, and doctors warned him that complications resulting from years of blood seepage through the hole could seriously threaten his health. The operation was hard on him, and recovery was long and painful.

"Because I waited so long to have the problem fixed, I’ll probably have hypertension for the rest of my life," Craig says.

No one wanted Joshua to have to go through open-heart surgery, but they also knew how dangerous it could be to wait. Many patients like Craig live with atrial septal defects for years. But because they allow blood to leak through the heart, these holes can lead to a condition known as right heart failure, caused by excess blood flow through the right side of the heart. Until very recently, the only way to repair such a defect was with open-heart surgery. Babies and children with atrial septum holes often were put on heart-lung bypass machines for many hours while surgeons opened their chests and repaired the holes by hand.

But in September 1999, the Food and Drug Administration approved a new device called the CardioSeal, which can be placed in the atrial wall using a heart catheter. Doctors at Children’s Hospital of Iowa completed the necessary training and protocols in January 2000, and Children’s Hospital of Iowa became one of the first 20 facilities in the country to perform this procedure.

"The CardioSeal is like two tiny umbrellas made of polyester fabric and held together with a metal frame," explains Thomas Fagan, M.D., a pediatric interventionalist at Children’s Hospital of Iowa. "During the procedure, which is performed in the Pediatric Catheterization Laboratory, the device is inserted to cover the hole. It’s much less invasive than surgery because we just use the veins of the body for entry. The best part is that recovery time is about 24 hours."

Joshua’s recovery was almost immediate. He was admitted on a Thursday in January, underwent the procedure on Friday, and returned to school the following Monday. Within a week, he was participating in noncontact sports. In August, after a postoperative check-up, Fagan gave him permission to join the eighth-grade football team.

"I’m going to play center," Joshua says happily. "The doctors said I’m perfectly OK now, and even if the quarterbacks come crashing into me, I can take it."