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 Craigs 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 heartjust
like his fathers.
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 soundsa whooshing, rasping noise, in between the typical
lubb-dubb heartbeatthat could have been caused by any number
of different conditions. Childrens 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 Joshuas 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, Ill
probably have hypertension for the rest of my life," Craig
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 Childrens Hospital
of Iowa completed the necessary training and protocols in January
2000, and Childrens 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 Childrens Hospital
of Iowa. "During the procedure, which is performed in the Pediatric
Catheterization Laboratory, the device is inserted to cover the
hole. Its 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."
Joshuas 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.
"Im going to play center," Joshua says happily.
"The doctors said Im perfectly OK now, and even if the
quarterbacks come crashing into me, I can take it."