[Verse 1] A twelve millimeter tube seems perfect for a newborn heart But months pass by and bodies grow while conduits stay the same The fixed orifice becomes a bottleneck, a choking art As pressure gradients climb and climb, the pathway bears the blame [Chorus] Somatic mismatch, neointima wraps around Valve degeneration, calcification pounds External pressure squeezes tight, the Achilles heel goes down Five mechanisms working hard to shut the conduit down [Verse 2] The body wraps what doesn't belong in layers thick and white Neointimal proliferation steals the lumen space away Like ivy creeping up a wall, it narrows day and night The foreign tube gets smaller as the tissue holds its sway [Chorus] Somatic mismatch, neointima wraps around Valve degeneration, calcification pounds External pressure squeezes tight, the Achilles heel goes down Five mechanisms working hard to shut the conduit down [Bridge] Three months the leaflets dance with grace By seven months they're locked in place Thickened, stiff, and calcified Both stenosis and regurgitation collide [Verse 3] Between the ventricle and sternum lies a narrow space Where compression steals the flow from tiny beating hearts Calcium deposits turn the flexible to stone-like face As biologic and synthetic both fall apart [Chorus] Somatic mismatch, neointima wraps around Valve degeneration, calcification pounds External pressure squeezes tight, the Achilles heel goes down Five mechanisms working hard to shut the conduit down [Outro] The RV-PA conduit bears the weight of truncus repair But failure's written in its fate, inevitable to bear
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