14-year-old boy realizes his football dream after specialists fix two serious heart defects

Visions of pinpoint passes and fingertip catches danced in Clayton Boltz’s head as he prepared for a seventh grade sports physical in July 2003.

It was just a routine checkup, of course. Physicals are required of any young Iowan wanting to play school sports. No one expected anything other than a normal outcome, although Clayton had a fleeting moment of doubt the night before.

“Mom, what if I don’t pass?”

Clayton’s parents, Ed and Diane of Sumner, Iowa, figured it was typical seventh grade angst. “Clayton,” Diane said, “everyone passes their sports physical.”

Well, not everyone. The next day, Joe Peraud, M.D., of the Fredericksburg Family Health Clinic, discovered a murmur in Clayton’s heart. Peraud referred Clayton to Samir Chandra, M.D., a cardiologist at Covenant Health Center in Waterloo. Clayton’s passionate dreams of playing football and basketball were suddenly on hold.

Chandra confirmed the problem, a narrowed aorta otherwise known as coarctation of the aorta, and realized that Clayton would benefit from specialized procedures at University of Iowa Children's Hospital, located at University of Iowa Hospitals and Clinics. To relieve the coarctation, UI pediatric cardiologist Thomas Fagan, M.D., threaded a catheter (a long, thin, flexible tube) into an artery in Clayton’s leg to place a metal stent in his aorta.

While this minimally invasive procedure was successful, the catheterization revealed another abnormality of his heart. Rather than originating from his aorta, Clayton’s circumflex coronary artery originated from his pulmonary artery.

This unusual congenital defect meant his other coronary artery had to work twice as hard to return pumped blood to the heart. It was only the seventh anomalous coronary artery of any type seen at UI Hospitals and Clinics. There have been only ten cases like Clayton’s (anomalous circumflex coronary artery originating from the right pulmonary artery) reported in the world literature.

The 94-pound youth would need a second surgery, this one an open-heart technique requiring a seven-inch incision in his chest. Cardiothoracic surgeon Harold M. Burkhart, M.D., performed the five-hour procedure in late September.  The operation involved stopping the heart and moving the small circumflex coronary artery from the pulmonary artery to the aorta.

“Everything went very well.  Clayton had complete recovery without any complications,” Burkhart says.

By October, Clayton was well enough to watch his beloved Iowa Hawkeyes beat Big Ten rival Michigan at Kinnick Stadium.

While thrilling, Clayton dreamed of playing football again, imagining himself someday as quarterback of the Hawkeye team.

He missed all of the 2003 football season, and still needed to pass a sports physical to be eligible in 2004.

Diane Boltz recalls the anxiety Clayton and the whole family felt over the physical. “Turns out it couldn’t have been better,” she says. “The doctors agreed there was no unnecessary risk. He was good to go.”

How ‘good to go’ Clayton really was became apparent in the very first game. Playing as a wide receiver for Sumner-Fredericksburg, he caught a 30-yard touchdown pass.

“We had waited a long time to see something like this,” Diane says. “We’re extremely grateful for the doctors who can give you a normal life again. It’s truly amazing what they can do.”

More information about heart services at University of Iowa Children's Hospital is available at the number listed below. For consultation or referral, physicians should call UI Consult.