[Verse 1] Blade down the midline, split that old pipe wide, Years of calcium turned the wall to shale inside, Chip it, peel it, flaky plates fall away, Friable chunks of limestone from a bygone surgery day, But hold the blade back where the posterior's glued tight, Leave a floor of scar so the root stays out of sight, Aortic wall's a whisper-thin neighbor through that haze, Coronaries hiding—respect the danger, cut with grace. [Chorus] Peel the shell, leave the floor, guard the root that's near, Run the suture to the fork, make the pathway clear, Left side kinked, right side pinched—open up the view, Patch it, stent it, watch the gradient, that's the move to do. [Verse 2] Now the distal join waits where the vessel splits in two, Bifurcation beckons—polypropylene sees it through, Running stitch unbroken, tension even, bite for bite, If a branch runs narrow, don't just tie it off tonight, Slice the arteriotomy further down the road, Homograft or pericardium carries the load, Widen out the doorway where the blood was squeezed too thin, Augment, don't amputate—let the flow roll in. [Chorus] Peel the shell, leave the floor, guard the root that's near, Run the suture to the fork, make the pathway clear, Left side kinked, right side pinched—open up the view, Patch it, stent it, watch the gradient, that's the move to do. [Verse 3] Rewind the tape to Rastelli, the Lecompte crossed the roads, Swapped the great vessels' highway, lightened old-tunnel loads, But years can shift the landscape—left PA bows back, Posterior pull creates a kink along the track, Right PA gets squeezed behind the aorta's wide stance, Compression like a doorway closing—give the lung a chance, Correct them both, reroute the bend, unclench the vise, A floppy vessel's freedom is the surgeon's quiet prize. [Verse 4] Old stents sitting in the branches, metal memory of the past, Cut them back, pull them free, or weave them into the graft, Some lesions are recalcitrant—stubborn, buried, deep, Reach them live on table, balloon and stent while patients sleep, Because remember this truth before you close the chest, Distal anastomotic narrowing fails the test, Leading cause of early trouble, numbers never lie, Get the fork wide open, or you'll operate again by and by. [Bridge] Floor, fork, kink, and stent—four words to keep in mind, Protect the root, open the gate, leave no vessel blind, Every millimeter matters where the two lungs meet, Sew it wide the first time, spare the second heartbeat. [Outro] Peel the shell, leave the floor, guard the root that's near, Run the suture to the fork, make the pathway clear, Left side kinked, right side pinched—open up the view, That's excision, that's reconstruction, now the lesson's through.
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