[Verse 1] When truncus needs repair, surgeons face a choice Four conduits available, each with its own voice Pulmonary homograft leads with hemodynamic grace Cadaveric arteries finding their new place [Chorus] P-A-G-B, remember the quartet well Pulmonary homograft rings the golden bell Aortic follows next with oversized appeal Gore-Tex synthetic strength, bovine jugular seal But here's the bitter truth that haunts each beating heart No conduit grows with children, they're destined to depart [Verse 2] Aortic homograft brings more tissue to the game Cadaveric valve and vessel, availability's its claim Though calcification creeps through biological walls Size mismatch complications echo through surgical halls [Chorus] P-A-G-B, remember the quartet well Pulmonary homograft rings the golden bell Aortic follows next with oversized appeal Gore-Tex synthetic strength, bovine jugular seal But here's the bitter truth that haunts each beating heart No conduit grows with children, they're destined to depart [Verse 3] Gore-Tex ePTFE offers consistent measurement Synthetic reliability, always in shipment Higher gradients lurk with pseudointimal peel Early stenosis strikes this artificial steel [Bridge] Bovine jugular whispers to the smallest frames Contegra's endocarditis plays dangerous games Hancock porcine wrapped in Dacron's embrace Long history shadowed by calcific chase [Verse 4] Twelve millimeters fits a newborn's chest today Four kilograms supported in surgical ballet But growth demands expansion, conduits cannot bend Three to five replacements mark this journey's end [Outro] From cradle through adulthood, reoperations planned The price of mended truncus, survival's shifting sand Choose wisely from the quartet, but know the lifetime cost Each conduit serves its season, then inevitably lost
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