[Verse 1] One root, one valve, the vessels share a single trunk, Truncus arteriosus, a newborn's wiring sunk. Surgeon lifts the pulmonary branches off that truncal wall, Patches up the VSD so the lone vessel serves them all, Then plants a conduit, right ventricle to PA, First week of life plumbing, no time to delay. That early pipe's the shortest-lived of any graft in town, Baby outgrows the valve before the stitches settle down. [Chorus] Six roads need a conduit, listen how they run, Truncus, Atresia, Rastelli, Ross, Double switch makes five, then one, Tetralogy with a crossing LAD, artery blocking the way, Right ventricle reaching, reaching for PA, Six different stories, one bridge we lay, RV to PA, say it, don't delay. [Verse 2] Pulmonary atresia, a hole sits in the floor, No highway from the pump out to the lung's front door, MAPCAs scatter blood flow, wild collaterals gone rogue, Surgeon gathers up the branches, that's unifocalize in vogue, Stitches scattered vessels into one pulmonary tree, Tetralogy with atresia walks this road, you see, Once the lung bed's unified and pressures check out right, Conduit links the chamber, RV to PA tonight. [Verse 3] Rastelli's for transposition, VSD, blocked LVOT, Can't send the left ventricle forward, so tunnel it instead, Baffle snakes the LV blood through the hole to the aorta's gate, Valved conduit carries right-side flow to compensate. Ross procedure borrows your own pulmonary gate, Moves it to the aortic post, autograft takes its place, Leaves a homograft standing where the old RVOT used to be, Outliving every cousin graft — longevity's its decree. Double switch for the corrected kind of swapped-around heart, Might borrow Rastelli's tunnel when the VSD plays its part. [Verse 4] Three to five percent of Fallot hide a coronary snare, LAD off the right side, crossing the infundibulum's lair, Cut the transannular patch there, you'd slice the artery through, So the surgeon lays a conduit, lets the coronary skate on through. Remember lifespan's written by the diagnosis at the start, Truncus and neonatal grafts calcify and fall apart, Homografts from the Ross procedure age the slowest of the crew, Same tube, different story, all depends on who walks through. [Bridge] Small valve, growing chest, pressure climbing like a tide, Gradient rising, z-score falling, nowhere left to hide, Diagnosis is the fortune-teller, read it and you'll know When the conduit you planted starts to calcify and slow. [Outro] RV to PA, six lesions, one highway through the chest, Know the road that brought you there, you'll know when to retest.
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