[Verse 1]
A twelve millimeter conduit placed with care
Perfect size for baby's heart repair
But months go by and the child will grow
While the conduit stays the same you know
The fixed orifice becomes too tight
Creating pressure gradients overnight
[Chorus]
Growth mismatch, tissue growth
Valve decay, calcium both
External squeeze completes the show
Five reasons why conduits go
The Achilles heel will always fail
In truncus repair, it tells the tale
[Verse 2]
The body sees this foreign piece
And wraps it up, it won't release
Neointimal layers start to form
Inside the tube, becoming the norm
Pseudointima grows along the wall
Making the pathway far too small
[Chorus]
Growth mismatch, tissue growth
Valve decay, calcium both
External squeeze completes the show
Five reasons why conduits go
The Achilles heel will always fail
In truncus repair, it tells the tale
[Verse 3]
Three months post-op, the leaflets move
Seven months later, they don't groove
The valve mechanism starts to thick
Calcium makes the tissue stick
Stenosis mixed with regurg too
Leaflet motion's nearly through
[Bridge]
Between the ventricle and chest
The sternum puts it to the test
External compression takes its toll
Especially when the child is small
Biologic or synthetic made
They all will calcify and fade
[Chorus]
Growth mismatch, tissue growth
Valve decay, calcium both
External squeeze completes the show
Five reasons why conduits go
The Achilles heel will always fail
In truncus repair, it tells the tale
[Outro]
RV to PA, the weakest link
Five pathways to failure, stop and think
The conduit fails, it's guaranteed
Plan for replacement, that's what we need