[Verse 1] Little chest, little conduit, built for a toddler's frame, Every swap's a loan against a future game, Small-size graft today means another cut tomorrow, Sternotomy number two, scar tissue they'll borrow, Surgeons stand at the crossroads, scalpel in the balance, Burden of the gradient versus patience and its talents, Twenty-two to twenty-six, that's the grown-up target zone, Fit the pipe to the body, not the body to the stone, Rush it young, you're signing up for chapters three and four, Patience buys a bigger tube that lasts you so much more. [Chorus] Wait for the size, weigh the strain inside, Window's not open till the vessel's qualified, Watch the growth curve, watch the pressure rise, Four W's keep the conduit timeline wise. [Verse 2] Stenotic tube, don't rush the knife, grab the balloon instead, Pop it, stretch it, bare-metal stent inside the bed, Buys you a median two, maybe three more years of road, But freedom comes with a cost the right ventricle's owed, Free pulmonary regurge, the valve's gone slack and open, Pressure load traded for volume, that's the bargain spoken, Squeeze turns to stretch, afterload turns to backflow, Chamber dilates slow, patient and team must track so, It's a loan, not a gift — the interest comes due, Volume creeps the chamber wide till surgery's overdue. [Chorus] Wait for the size, weigh the strain inside, Window's not open till the vessel's qualified, Watch the growth curve, watch the pressure rise, Four W's keep the conduit timeline wise. [Verse 3] Growth spurt hits like a key change nobody saw coming, Shoe size jumps, so does the gradient, the heart starts drumming, Kid wants cleats, wants the whistle, wants the competitive field, Elective timing steps up before that collision's revealed, Years later, a young woman planning for two heartbeats under one ribcage, Conduit's gotta handle double the cardiac output at that life stage, Spurts, sports, and pregnancy — three doors marked "decide now," Miss the cue and the next echo will show you exactly how. [Bridge] Don't just read the MRI number, read the kid in the hallway too, School grades slipping, needle-anxious, counting sternotomies they've been through, Neurodevelopment, psychosocial weight on the family ledger, Shared decision, not a solo call — surgeon, parent, and the pledger, Cumulative risk of reopening that same scarred-up door, Weigh it against the hemodynamic burden they can't ignore, Every number on the scan is just one voice in the room, Listen to the whole kid before you schedule the room. [Chorus] Wait for the size, weigh the strain inside, Window's not open till the vessel's qualified, Watch the growth curve, watch the pressure rise, Four W's keep the conduit timeline wise. [Outro] Small pipe, big decision, every year's a different verse, Balloon buys time, but regurgitation's the reverse, Spurt, sport, or pregnancy — the inflection finds its hour, Time the cut right, and you bank the whole family's power.
← Guideline Thresholds for Intervention | Surgery Versus Transcatheter Valve →