[Verse 1]
The examiner leans in, the vignette unfolds—
"Baby, four weeks old, a murmur, so I'm told."
Perimembranous, eighty percent of the game,
Right below the crista, near the tricuspid's frame.
Watch the aneurysm tissue, tricuspid septal leaflet dance,
It might just seal itself—give the shunt a fighting chance.
[Verse 2]
She counters with vignette two, muscular and sly,
"Swiss cheese in the septum," she says with a knowing eye.
Multiple defects, trabecular, hard to trace,
Most will close on their own—time heals this space.
But watch the echo windows, don't let one defect hide,
Behind another shadow on the left ventricular side.
[Chorus]
Seis casos, six cases, the jury wants it clear—
Defend your plan, mon amour, before the strings disappear.
Perimembranous, muscular, inlet, outlet, calling out,
Doubly-committed, then the storm—that's what the exam's about.
Sing it soft, sing it sharp, cada tipo tiene voz,
Six études en chambre, on and on it goes.
[Verse 3]
Vignette three arrives, a cushion gone astray—
Inlet type, AV canal, common atrioventricular way.
Trisomy twenty-one whispers through the chart,
One valve for two chambers, torn right from the start.
Primum ASD beside it, a full canal in view,
Surgical repair by infancy—that's the plan that's true.
[Verse 4]
Now outlet, supracristal, conal septum thin,
Aortic cusp starts prolapsing, sucked toward the sin.
Doubly-committed juxta-arterial, no muscle rim at all,
Watch that valve for regurgitation—early closure stalls the fall.
Two arteries, one border, semilunar valves in reach,
Close it before insufficiency writes its own dark speech.
[Chorus]
Seis casos, six cases, the jury wants it clear—
Defend your plan, mon amour, before the strings disappear.
Perimembranous, muscular, inlet, outlet, calling out,
Doubly-committed, then the storm—that's what the exam's about.
Sing it soft, sing it sharp, cada tipo tiene voz,
Six études en chambre, on and on it goes.
[Bridge]
Vignette six—the trap, the twist, the complication's throne:
Unrepaired for years, pressures climbing on their own.
Eisenmenger creeping, the shunt reversing blue,
Clubbing on the fingers—what's the harm you mustn't do?
No surgery once the pulmonary bed has turned to stone,
Say it, defend it, let the strings groan and moan—
Timing is the answer, closure before the crossover's known.
[Verse 5]
Piano holds its breath, the panel waits in line,
Six vignettes behind you, and the verdict starts to shine.
Say the anatomy, say the risk, say the fix,
Say why waiting kills you where the numbers mix.
Le patient, la paciente, cada caso cuenta bien—
Answer like you've lived it, not just read it in a book again.
[Outro]
Seis casos, six cases, the strings pull to a close,
Perimembranous to Eisenmenger—that's the arc it goes.
Defend it, mon amour, cada tipo, one by one,
The exam room falls to silence when the final note is done.