[Verse 1] Listen how the conus septum forgot to arrive, One great vessel, both ventricles feeding inside, The infundibular septum's absent, that's the crime, So the hole beneath the valve was written into design. Call it "associated," and you'd be telling a lie, It's the malalignment where the trunk overrides, Same failure of septation, same broken divide, The VSD's the truncus's twin, born on the same tide. [Chorus] Hold the hole — it's part of the plan, Match the mouth where the button began, Watch the growth, the heart's still in your hand, Trace the arch where the vessels ran. [Verse 2] Type two, the arteries huddle up close, sharing one lip of tissue, a single duct root, Cut one wide button, both mouths ride along, Sutured back easy — the geometry sings its own song. Type three, the vessels split, they've drifted apart, Each ostium alone, closer to the valve's own heart, Carve that button now, you risk the commissure's line, Distort one leaflet, you've distorted the whole design. [Chorus] Hold the hole — it's part of the plan, Match the mouth where the button began, Watch the growth, the heart's still in your hand, Trace the arch where the vessels ran. [Verse 3] Complete don't mean finished, it means today's repair, The homograft you sewed in won't grow with the heir, Calcium creeps in, the conduit tightens its grip, The truncal leaflets thicken, they warp, they slip. Rhythm can wander where the patch meets the wall, Years down the road bring a different recall, So echo, and holter, and cath every stage — Complete is a chapter, not the end of the page. [Verse 4] Flip the arch to the right, and the order reverses, First vessel off: the left brachiocephalic disperses, Then the right carotid climbs its own private stair, Then the right subclavian breathing separate air. Mirror-image branching, predictable, neat, Pairs with tetralogy, pairs with truncus's beat, But when the left subclavian trails off alone, A vascular ring may circle the windpipe's own home. [Bridge] Four questions, one chest, one truth laid bare, The defect, the button, the years, the air, Anatomy whispers what pathology wrote, Listen closer — the heart keeps its own footnote. [Chorus] Hold the hole — it's part of the plan, Match the mouth where the button began, Watch the growth, the heart's still in your hand, Trace the arch where the vessels ran. [Outro] Not associated — woven in the frame, Type two, type three — geometry's the name, Complete repair still answers to the calendar's claim, Right arch, mirrored branches — same vessels, new aim.
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