[Verse 1]
Numbers on the chart but nobody's sure when to cut,
RVEDVi climbing, RVEF going kaput,
RVESVi index, QRS stretching wide,
Exercise threshold flashing red on the backside,
Every number's drawn from watching, not from testing,
Observational cohorts, no randomized investing,
We stare at the curve, guess the perfect station,
Timing's still a riddle with no equation.
[Chorus]
Question sans réponse, on cherche encore
Pas de réponse claire, mais on explore
No trial to confirm it, numbers tell a tale
Question sans réponse — the data's still too pale
[Verse 2]
Post-op pharmacy, what's the right prescription?
Aspirin or nothing, that's the ongoing friction,
How long do we dose it, three months or forever,
Does anticoagulation stop the leaflets clumping together,
Thrombosis on the valve or bugs that find a home,
Endocarditis creeping where the clot once used to roam,
No consensus chart, just scattered small cohorts,
Guidelines shrug their shoulders, écrivent "encore."
[Chorus]
Question sans réponse, on cherche encore
Pas de réponse claire, mais on explore
No trial to confirm it, numbers tell a tale
Question sans réponse — the data's still too pale
[Verse 3]
Bovine jugular tissue, built tough, built strong,
But endocarditis rates keep singing the wrong song,
Why does the collagen draw the bacteria in,
Surface structure, calcium, the roughness of its skin,
Tissue modification might smooth the invitation,
Wider prophylaxis, tighter patient selection,
But the mechanism's murky, hiding in the weave,
La raison reste cachée — nobody's got the key.
[Bridge]
Newborn heart, the conduit's too small too soon,
Somatic growth outpaces it by the second moon,
Every graft we've tried still can't keep the pace,
A growth valve is the prize, the field's unsolved embrace,
On cherche le Graal, stretching with the child,
Till then every neonate's conduit's compiled.
[Verse 4]
Valve-in-valve, valve-in-valve, stacking through a lifetime,
Five or six times through — is that the right paradigm,
Each new nested valve shrinks the room inside,
Does the immune system keep score on every ride,
Could all that antigen exposure shut the door,
To transplant candidacy somewhere down the floor,
Long-term data's thin, the follow-up too short,
Mais le futur répondra — that's our last resort.
[Chorus]
Question sans réponse, on cherche encore
Pas de réponse claire, mais on explore
No trial to confirm it, numbers tell a tale
Question sans réponse — the data's still too pale
[Outro]
Timing, treatment, tissue, growth, and chain of valves,
Five unresolved chapters the textbook still halves,
On ne sait pas tout, mais on apprend quand même,
Keep the question open — science earns its crème.