[Verse 1] Down in the inlet, under the floor where the tricuspid leans, there's a gap with no muscle guarding what it means — no rim of red tissue between the hole and the hinge, so the valve and the defect share a single fringe. This one climbs to the annulus, wears no border, no wall, a silence where a septum should be standing tall. [Chorus] Inlet type, no rim in sight, node and bundle sleeping just to the right — call it AV-canal, call it trisomy's kin, the patch must go careful where the conduction has been. Three, the third, the inlet call, Down's own shadow on the wall. [Verse 2] Look close at the annulus, the chordae strung like thread — sometimes they straddle, crossing where the septum should have spread. That changes the math the surgeon does at night, whether one valve or two will hold the line tight. It's the calling card of AVSD, the spectrum's beating heart, where atrium and ventricle forget where they should part. [Chorus] Inlet type, no rim in sight, node and bundle sleeping just to the right — call it AV-canal, call it trisomy's kin, the patch must go careful where the conduction has been. Three, the third, the inlet call, Down's own shadow on the wall. [Verse 3] It never learns to whisper shut, never seals on its own, so the shunt comes early, loud, before the child has grown. No device will nest here, no catheter's small key — only patch and suture, only hands that see. Trace the chordae inch by inch before you sew, for the bundle's just a heartbeat from where the needle goes. [Bridge] Beneath the leaflet, quiet as a held breath, the node keeps watch like something close to death — one careless stitch, the rhythm starts to drown, so the surgeon reads the map before the thread goes down. Twenty-one's own signature, written in the wall, the inlet keeps the reason for the whole AV-canal. [Verse 4] Some call it primum's cousin, some call it a different name, but the echo tells the difference, the anatomy's the same — a common ring of tissue where two rings ought to be, one valve trying to serve two chambers, awkwardly. The surgeon splits what nature never quite divided right, stitching borders back to order, giving structure back its sight. And still that node keeps sleeping, tucked beneath the crest, a small unmarked grave the needle must not test. Every case writes its own map, every heart its own terrain, but the inlet always whispers where the danger lies again. [Chorus] Inlet type, no rim in sight, node and bundle sleeping just to the right — call it AV-canal, call it trisomy's kin, the patch must go careful where the conduction has been. Three, the third, the inlet call, Down's own shadow on the wall. [Outro] No rim, no closing, no small machine to send — just patient hands and patience, until the story's end.
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