Specialized Curriculum: Type II Truncus Arteriosus
Subject: Specialized Curriculum: Type II Truncus Arteriosus
11 chapters
1. One Trunk, Two Mouths, One Wall
[Verse 1]
One great vessel leaves the heart, straddling the wall that split in two,
Systemic, lung, and coronary — all drink from the trunk it grew through.
Call it common, call it singular, the septum never closed its door,
This is the ground floor of the lesson, before we count the forms it wore.
[Chorus]
Two mouths, one wall — that's the Collett-Edwards call,
Posterior, posterolateral, side by side they fall.
No trunk between them, just a fork where the vessel splits in air,
Type Two, Type Two — separate holes but the same lung pair.
[Verse 2]
Picture the back of that single artery, low and leaning behind,
Right and left pulmonary arteries rising, adjacent, intertwined.
Not fused into one stem like Type One's single pulmonary door,
Two distinct ostia, close as neighbors, but each one keeps its own floor.
[Chorus]
Two mouths, one wall — that's the Collett-Edwards call,
Posterior, posterolateral, side by side they fall.
No trunk between them, just a fork where the vessel splits in air,
Type Two, Type Two — separate holes but the same lung pair.
[Verse 3]
Cross the aisle to Van Praagh's naming, A2 answers the same design,
No main pulmonary segment standing, just two origins in a line.
Different language, same anatomy, two systems shaking hands,
Nosology's a translator, not a border drawn in sand.
[Bridge]
Now a few millimeters of pulmonary trunk can blur the line we drew,
Type One bleeds softly into Two — the textbook isn't always true.
Surgeons say the difference matters little once the patch is sewn,
Classification's a compass, not the shape of flesh and bone.
[Verse 4]
One, maybe two, in a hundred hearts wear this truncal design,
Type One and Type Two together claim eighty-five of every line.
Rare enough to study closely, common enough to bear a name,
Know the boxes, know their limits — the anatomy's still the same.
[Verse 5]
Back in the fourth week, the truncal ridges spiral and try to meet,
A conotruncal fault line lingers where the septum fails to complete.
Neural crest cells whisper the pattern, migration falling short,
Leaving one artery to answer for what should have been two doors at the aorta's court.
Echo the arch, echo the valve, watch how the leaflets divide,
Every subtype tells the same story of a septum that never tied.
[Chorus]
Two mouths, one wall — that's the Collett-Edwards call,
Posterior, posterolateral, side by side they fall.
No trunk between them, just a fork where the vessel splits in air,
Type Two, Type Two — separate holes but the same lung pair.
[Outro]
Separate ostia, posterior wall, no trunk to bridge the two —
Hold the picture, not the label, and the anatomy sees you through.
2. Two Ostia, One Whispered Root
[Verse 1]
Listen close, the trunk divides its story here,
Not one gate but two, set close or far, a whispered frontier,
Posterior wall, sometimes drifting left and low,
Separate ostia, that's the clue you need to know,
The distance between them shifts from case to case,
Measure the gap before you map the space.
[Chorus]
Two ostia, one common root,
Posterior wall is where they shoot,
Spiral apart, or crossing tight,
Type Two's secret hides in plain sight,
Left goes high, right dips below,
Remember the twist before you go,
Two ostia, one trunk, one truth,
That's the fingerprint of Type Two.
[Verse 2]
Now follow the branches as they wind and lean,
A spiral course, a crossing scene,
Left artery climbing anterior and up so proud,
Right one sinking posterior, low beneath the cloud,
Or reverse the pattern, the map can turn about,
Surgeons trace this twist before they cut it out,
Because the conduit's landing spot depends upon the bend,
Get the geometry wrong, and the graft won't mend.
[Verse 3]
Below the valve a window opens wide,
Subarterial VSD, ten to fifteen millimeters side to side,
A fibrous rim sits proudly at the top,
While down below the conduction fibers never stop,
The bundle of His runs quiet, tucked and near,
Respect that rim, or the rhythm you'll impair.
[Chorus]
Two ostia, one common root,
Posterior wall is where they shoot,
Spiral apart, or crossing tight,
Type Two's secret hides in plain sight,
Left goes high, right dips below,
Remember the twist before you go,
Two ostia, one trunk, one truth,
That's the fingerprint of Type Two.
[Verse 4]
One valve to rule the outflow, thick and strange,
Three leaflets mostly, sixty-five to seventy in range,
Four cusps appear in one case out of five,
Two cusps show up rarer, still it thrives,
Dysplastic, floppy, thickened tissue at its core,
This valve wears damage that the trunk cannot ignore.
[Bridge]
Right aortic arch bends the mirror plane,
Left brachiocephalic leads the mirror-image train,
Thirty percent, this quirk loves Type Two best,
A foramen ovale left open, uninvited guest,
Coronaries wander, single ostium, crossing paths unseen,
Right through the ventriculotomy, sneaking in between,
Twenty-two Q eleven, the missing thread,
Thirty to forty percent carry it instead,
Widely separated origins — that's Type Three, not this,
And absent branch entirely — call that A3, don't miss,
Type Two stands between them, close but still apart,
Separate doors, one lintel, that's the anatomic art.
[Chorus]
Two ostia, one common root,
Posterior wall is where they shoot,
Spiral apart, or crossing tight,
Type Two's secret hides in plain sight,
Left goes high, right dips below,
Remember the twist before you go,
Two ostia, one trunk, one truth,
That's the fingerprint of Type Two.
[Outro]
Posterior doors, a spiral thread,
The rim, the valve, the arch instead,
Type Two whispers what the heart concealed,
Now the anatomy stands revealed.
3. One Root, Two Mouths
[Verse 1]
Two great vessels shackled into one wide gate,
Systemic blood and lung blood mingle, refuse to separate.
Newborn lungs still soft, resistance dropping fast,
Flood tide rushing forward, no valve to make it last.
Weeks one and two, the chest wall starts to heave,
Sweat on tiny foreheads, milk they can't receive.
Overcirculation drowns the alveolar shore —
Heart failure knocking early, softly at the door.
[Chorus]
No main trunk, just two open mouths that share one root,
Ostia side by side — that's the type two truth.
Nakata counts the branches, Z-score tells you how they grow,
Truncal valve is watching, gradient's the word to know.
Sing it: mixing, flooding, failing — that's the play,
Type two truncus, ostia twins, showing us the way it's laid.
[Verse 2]
Slide the probe up high, parasternal, tilted steep,
Suprasternal window opens what the sternum tries to keep.
Look for one great artery — you won't find it there,
Instead two separate openings, breathing the same air.
Follow each ostium, trace it left and right,
Measure where they narrow, measure where they're tight.
No confluence, no trunk stem, just a forking, silent split —
Echo's quiet verdict, and the surgeons study it.
[Verse 3]
Branch diameters whisper in millimeters small,
Z-scores translate whispers into numbers we recall.
Nakata index sizes up the pulmonary bed,
Tells us if the lungs can handle what's ahead.
Now the truncal valve — count its leaflets, watch it close,
Regurgitation backward, listen how the pressure flows.
Gradient across it warns of stenosis brewing near,
Then the arch: which side it takes, which vessel's first to steer.
[Bridge]
CT angiography, the mapmaker of the chest,
Charts the pulmonary ostia, finds where coronaries rest.
Spiral courses wander — call it peregrination,
A wandering, looping journey, a vessel's own migration.
Right arch or left, the order of the great vessels shown,
Surgeons need this atlas before the first cut's known.
[Verse 4]
Catheter's held in reserve, not the opening move,
Saved for late presenters when the picture's hard to prove.
Pulmonary vascular resistance, climbing, thick and slow,
Numbers from the wedge and lungs tell what the vessels know.
Too high, and surgery waits, too high, and time has cost —
The window for repair could quietly be lost.
[Chorus]
No main trunk, just two open mouths that share one root,
Ostia side by side — that's the type two truth.
Nakata counts the branches, Z-score tells you how they grow,
Truncal valve is watching, gradient's the word to know.
Sing it: mixing, flooding, failing — that's the play,
Type two truncus, ostia twins, showing us the way it's laid.
[Outro]
Two ostia, one root, spiraling their way —
Echo finds them, CT charts them, cath waits out its day.
4. Single Button, One Clean Snip
[Verse 1]
Clock starts ticking on the day of birth,
one great vessel doing double the work,
four to six weeks, that's the window we chase,
before the lungs flood and the shunt wins the race.
Type Two whispers where the branches sit close,
both pulmonary mouths on a shared little coast,
so tight together, so near the same wall,
that's the edge we're given, the gift in it all.
[Chorus]
Single button, cuff of truncal wall,
one clean snip frees the pair of ostia both,
Six weeks or sooner, don't let it stall,
Spiral steer wide, no kink, no coax.
Patch it, plumb it, protect the node,
Right vent opens on the avascular road,
Single button, six-week code —
sing it back so the graft never blows.
[Verse 2]
Excise the ostia together as one,
en bloc with a collar where the truncal wall spun,
Type Two's the favor Type Three never gets,
adjacent openings, no separate frets.
The aorta's left with a gap in the seam,
sew it shut direct or bridge it with a gleam
of glutaraldehyde pericardium spread,
autologous tissue, treated and fed.
[Verse 3]
Now watch the spiral where the vessels twist behind,
orient that conduit or you'll strangle the line,
kink the left, choke the right, and the flow runs dry,
sometimes translocate, reimplant, don't ask why.
Cut the right ventricle where the vessels won't run,
avascular window, coronary map done,
trace the artery before the knife finds its place,
skip that step and you can't save face.
[Chorus]
Single button, cuff of truncal wall,
one clean snip frees the pair of ostia both,
Six weeks or sooner, don't let it stall,
Spiral steer wide, no kink, no coax.
Patch it, plumb it, protect the node,
Right vent opens on the avascular road,
Single button, six-week code —
sing it back so the graft never blows.
[Verse 4]
The VSD's subarterial, patched from the right,
right atrial window keeps the conduction in sight,
sometimes a ventriculotomy opens the view,
but the bundle stays sacred — that's rule number two.
Homograft's the standard, the gold in the bank,
Contegra the xenograft waiting in rank,
Gore-Tex when the shelf runs empty and bare,
ten to twelve millimeters, the neonate's wear.
[Bridge]
Barbero-Marcial skips the conduit chain,
direct RV-to-PA, less plastic, less strain,
Right arch bending? Cannulate with care,
reangle the conduit, mind what's not there,
Sternum stays open when the heart's still swollen and tight,
delayed closure buys the tissue its quiet respite.
[Chorus]
Single button, cuff of truncal wall,
one clean snip frees the pair of ostia both,
Six weeks or sooner, don't let it stall,
Spiral steer wide, no kink, no coax.
Patch it, plumb it, protect the node,
Right vent opens on the avascular road,
Single button, six-week code —
sing it back so the graft never blows.
[Outro]
Single button, six-week clock,
Spiral steer around the block,
Protect the node, size the shunt,
Type Two repaired — that's the front.
5. One Root, Two Disguises
[Verse 1]
(Male) The truncal valve leaks, three leaflets gone unruly,
Resuspend the flaps or carve them into two, cool and duly—
(Female) Bicuspidize the tissue, buy the ventricle some time,
But when the cusps are ravaged, swap it out — no leaflet left to climb.
(Male) Repair when there is tissue with a fighting chance to hold,
(Female) Replace when regurgitation's story's already told.
[Chorus]
Truncus, truncus, one root wearing two disguises,
Watch the gradient rising while the pulmonary bed compromises.
Conduit's a candle, burning short from the very start,
Resuspend, replace, reintervene — that's the surgeon's art.
Neo-aorta, never sleeping, watch it all your days,
Type Two truncus teaches patience pays.
[Verse 2]
(Female) Type Two meets interrupted arch — the aorta severed, torn,
(Male) One pump session, single stage, before the newborn's worn.
(Female) Reconstruct the gap in one long breath, don't stagger the attack,
Overlap with A-Four's lesson — mend the arch and root, don't look back.
(Male) The window's narrow, the tissue's fragile, the stakes are sky-high steep,
(Female) One-stage repair, or risk a second surgery you can't keep.
[Verse 3]
(Male) Now the RV-to-PA conduit — it's a promise built to break,
Homograft, xenograft, whichever — stenosis is the fate it'll make.
(Female) Echo tracks the gradient climbing, quarter by quarter, year by year,
Right ventricular pressure whispers when it's time to interfere.
(Male) Peak gradient, RV pressure creeping past the systemic line,
(Female) That's the threshold — that's the signal — intervention time.
[Chorus]
Truncus, truncus, one root wearing two disguises,
Watch the gradient rising while the pulmonary bed compromises.
Conduit's a candle, burning short from the very start,
Resuspend, replace, reintervene — that's the surgeon's art.
Neo-aorta, never sleeping, watch it all your days,
Type Two truncus teaches patience pays.
[Verse 4]
(Female) Balloon the conduit, stretch the scar, or drop a stent inside,
(Male) Melody or Sapien valve, transcatheter, no need to open wide.
(Female) Watch the branches, left and right, where they were sewn back on—
Ostial stenosis lurks right where the reimplant's drawn.
(Male) Catheter first, before the knife — the modern order of the day,
(Female) But surgery still waits its turn when catheters can't clear the way.
[Bridge]
(Male) Redo, redo, serial replacement, each conduit a little bigger,
(Female) Enlargement strategies stretching runway for a growing figure.
(Both) Ninety percent survival now in centers built for this fight,
Most will meet the pulmonary pathway's needle before they reach their rite—
(Male) Adulthood arrives with scars still open, still being read,
(Female) The neo-aortic root demands its watch till life's last thread.
6. Spiral Roots, Steady Hands
[Verse 1]
Load the angiogram, slice by slice we're spinning,
Type two truncus, twin pulmonary roots beginning,
Watch the spiral course, how the branches twist and lean,
Rotate the render till the vessel's fully clean.
Mark the ostium, measure the take-off angle,
Every millimeter matters when the conduit starts to dangle.
[Chorus]
Trace it, cut it, turn it, check it — коло shows the way,
Спіраль веде судину, don't let the branch decay.
Ostium excised, orient the graft, тримай,
Разом ми вчимось — this is the truncus way.
[Verse 2]
Printed model on the table, resin warm from the press,
Practice ostial excision, trim the button, nothing less,
Turn the distal graft until the flow lines all agree,
Anastomosis oriented — no kink, no twist, no plea.
Feel the needle bite the wall, count your stitches nice and true,
The silicone won't forgive you, so the living heart won't too.
[Chorus]
Trace it, cut it, turn it, check it — коло shows the way,
Спіраль веде судину, don't let the branch decay.
Ostium excised, orient the graft, тримай,
Разом ми вчимось — this is the truncus way.
[Verse 3]
Roll the footage, case reviews, type two repairs in view,
Debate the conduit's rotation — clockwise or the counter crew,
Anterior, posterior, which orientation wins the day,
Watch the valve sit level while the branches find their way.
Freeze the frame on tension points, argue what the surgeon chose,
The orientation whispers where the future stenosis grows.
[Bridge]
Simulated morbidity, mortality room,
Early branch stenosis creeping back to loom.
Reimplantation tension, angle drawn too tight,
Дивись уважно — catch it before the flight.
Was it the suture line, or the twist we let it keep,
Every case a lesson that we carry into sleep.
[Chorus]
Trace it, cut it, turn it, check it — коло shows the way,
Спіраль веде судину, don't let the branch decay.
Ostium excised, orient the graft, тримай,
Разом ми вчимось — this is the truncus way.
[Verse 4]
Now the fellows gather round the second printed heart,
Swap the scalpel hand to hand, each one plays their part,
Measure twice, cut once, let the calipers decide,
Where the ostium sits best along the conduit's side.
Someone whispers, "watch the angle, watch the branch don't strain,"
Lessons from the workshop echo, sinking into every vein.
We build the muscle memory, the eye that learns to trust,
The spiral of the vessel, and the reasons that we must
Rotate with purpose, never guess, never rush the graft,
Because a steady hand today becomes tomorrow's craft.
[Outro]
Спіраль, судина, серце — practice makes us sure,
Trace it, cut it, turn it, check it, till the fix is pure.
Одна судина, два шляхи — hold the angle, hold the line,
Type two truncus, we've got this, workshop after workshop, fine.
[Chorus]
Trace it, cut it, turn it, check it — коло shows the way,
Спіраль веде судину, don't let the branch decay.
Ostium excised, orient the graft, тримай,
Разом ми вчимось — this is the truncus way.
7. One Vessel Where Two Should Divide
[Verse 1]
Seventeen ninety-eight, a candlelit room,
Wilson leans close to a heart out of tune,
One vessel only, where two should divide,
The truncus arteriosus, laid open and wide.
Through the eighteen-hundreds the pathologists came,
Sketching the silence no scalpel could name.
[Verse 2]
Buchanan in eighteen sixty-four,
Traces the septum that never tore,
Charts every cusp and every seam,
Turns a strange curiosity into a theme.
He gives it dimension, a shape we can hold,
The first careful portrait of a heart growing old.
[Chorus]
Sing the names, keep the thread,
Wilson, Buchanan, the words that they said,
One trunk carries the blood of the whole,
Four types, then five letters, a nosology's toll —
That's the science of how we divide and we call,
History layered like plaster on an old church wall.
[Verse 3]
Nineteen forty-nine, the Mayo Clinic halls,
Collett and Edwards among the marble walls,
One hundred sixteen hearts laid out in a row,
Types one through four, a postwar tableau.
Where the pulmonary arteries choose to depart
Decides which numeral gets stitched to the heart.
[Verse 4]
Nineteen sixty-five, the Van Praaghs arrive,
Segment by segment they keep it alive,
Pseudotruncus cast out, no longer type four,
A1 through A4, and B waits at the door.
The argument echoes in journals today,
A palimpsest science keeps writing over, they say —
old text beneath new text, but nothing thrown away.
[Chorus]
Sing the names, keep the thread,
Wilson, Buchanan, the words that they said,
One trunk carries the blood of the whole,
Four types, then five letters, a nosology's toll —
That's the science of how we divide and we call,
History layered like plaster on an old church wall.
[Bridge]
Two thousand and something, the nomenclature bends,
One name for the trunk, and the old feuding ends,
"Common arterial trunk," a truce carved in ink,
While embryologists trace where the story might link.
Kirby in the eighties, watching neural crest cells migrate,
Twenty-two Q eleven, TBX1, the gene that miscalculates.
[Verse 5]
From candlelight tables to double-helix maps,
The heart keeps its secret through centuries and gaps,
Wilson could not know what a chromosome meant,
But the artery he drew is the same one we've bent
Into molecules, migration, and name —
One truncus, one mystery, one long-running claim.
[Outro]
So hum the timeline, low and slow,
Wilson to Kirby, watch the knowledge grow,
One trunk becomes types, becomes segments, becomes genes,
The palimpsest heart still tells us what it means.
8. One Trunk, Two Futures
[Verse 1]
Fifties into sixties, overcirculation's flood
Surgeons reached for banding, tightening the blood
But truncus wouldn't listen — type II split the road
Two branches, two arteries, one band could not hold
[Chorus]
Del banding al bypass, corazón que aprende
Historia nos enseña cómo el cirujano mends
One trunk, two futures, homograft and hope entwined
Sigue latiendo — keep the story in your mind
[Verse 2]
Nineteen sixty-two, Behrendt dared to try
Cardiopulmonary bypass just learning how to fly
Early hands on truncus, the pump still finding ground
Repair was just a whisper, not yet a steady sound
[Verse 3]
Sixty-seven, Rastelli sketched a valve inside a tube
A conduit, right ventricle to lung, a channel freshly hewed
McGoon and Ongley, Mayo Clinic, sixty-eight
Aortic homograft sewn in — the turning point, the gate
Ross and Barratt-Boyes were rising, homografts became the creed
Valved against the valveless, a debate began to seed
[Chorus]
Del banding al bypass, corazón que aprende
Historia nos enseña cómo el cirujano mends
One trunk, two futures, homograft and hope entwined
Sigue latiendo — keep the story in your mind
[Verse 4]
Ebert, out in San Francisco, nineteen eighty-four
Infants under six months, kicked open the door
No more stalling, no more banding, buying desperate time
Early repair proved braver — the little ones could climb
[Bridge]
Hanley and Bove refined it, neonates upon the table now
Barbero-Marcial, ninety, grew a conduit-free bough
Bonhoeffer, two-thousand, slipped a valve through catheter's thread
Follow-up transformed forever, no more opening the chest instead
Where the clinics thin and truncus comes in late and underseen
Surgeons still rewrite the story — courage fills the in-between
[Verse 5]
Homograft, then the xenograft — Hancock, Contegra sewn
Dacron and Gore-Tex, synthetic corridors we've grown
But calcium finds its canvas, efflorescence blooms like frost,
That chalky bloom of failure taught us what the tissue cost
[Verse 6]
Fetal echoes catching truncus long before the birth
Genetics whisper twenty-two q, deletion's hidden worth
DiGeorge shadows every conduit, every graft we place
Team of surgeon, geneticist, cardiologist embrace
Registries now span the decades, outcomes charted, lessons kept
Every reoperation teaches what the pioneers had swept
Into footnotes, into data, into hands that operate today
Truncus arteriosus still is teaching — still will teach the way
[Chorus]
Del banding al bypass, corazón que aprende
Historia nos enseña cómo el cirujano mends
One trunk, two futures, homograft and hope entwined
Sigue latiendo — keep the story, keep the mind
[Outro]
Band it, mend it, grow it, free it — watch the timeline turn
Cada válvula cuenta historias — this is how we learn
From Rastelli's sketch to catheters threading through the vein
Un corazón, dos caminos — the lesson stays the same
9. One Long River Through the Trunc
[Verse 1]
Nineteen forty-nine, two names on a single ledger,
Collett and Edwards counting chambers, calling out the order,
Type One, Two, Three, Four, how the pulmonary vessels scatter,
Their tally built from autopsy tables, small and scattered matter,
A few dozen hearts can't hold every child's own tempo,
Read it close, the bias hides inside the echo.
[Chorus]
Collett counts it, Van Praagh doubts it,
McGoon stitches it, Ebert tracks it out,
Four papers, one long river running through the truncus,
Read between the numbers, that's the lesson meant for us.
[Verse 2]
Sixty-five, Van Praagh redraws the river's boundary,
Splits the septal story, weighs embryology against anatomy,
A-one to A-four, the VSD becomes the compass needle,
Some called it splitting hairs, others crowned it regal,
Two schools of thought, each holding half a candle,
The map depends on which hand grips the handle.
[Chorus]
Collett counts it, Van Praagh doubts it,
McGoon stitches it, Ebert tracks it out,
Four papers, one long river running through the truncus,
Read between the numbers, that's the lesson meant for us.
[Verse 3]
Walk the quiet halls where glass jars keep their vigil,
Autopsy registers in copper ink, fragile as a hymnal,
Specimen four-forty-two, a heart that never rounded,
Museums as the witness stand where every diagnosis gets grounded,
Each catalog card, a small anonymous confession,
History's stethoscope pressed against the collection.
[Verse 4]
Mayo built the tunnel, McGoon's valve set deep inside it,
Great Ormond Street slowed the timing, watched the newborn survive it,
Soviet clinics worked in parallel, their papers slow to travel,
Cold winters kept the echo films from crossing gravel,
Same defect, three separate schools of patience,
Compare the outcomes, never just equations.
[Bridge]
Ebert, eighty-four, traced them years past cutting,
Late conduits calcify, the growing heart keeps outgrowing what we're trusting.
Whose consent could speak for an infant on the table?
Learning curves cost lives before the data turned stable,
Name it plainly, never erase it in the telling,
Innovation often wore the mask of knowing, not of knelling.
[Chorus]
Collett counts it, Van Praagh doubts it,
McGoon stitches it, Ebert tracks it out,
Four papers, one long river running through the truncus,
Read between the numbers, that's the lesson meant for us.
[Outro]
Every register, every archived breath,
Teaches the surgeon what the paper left unsaid,
Four names, one truncus, history still runs ahead.
10. One Trunk, Two Branches, One Truth
[Verse 1]
A single trunk, one valve to serve them all,
Pulmonary branches spiral before they fall,
Right arch curling where the left should bend,
Echo finds the shadow, CT draws the end.
Newborn chest, still learning how to breathe,
Two doctors lean in closer than the eye can see.
[Verse 2]
Twelve millimeters, conduit stitched with care,
Threading a passage where the trunk once flared,
Type Two whispers: branches sitting close, not far,
Collett and Edwards charted where we are.
Ten months later, pressure climbing steep,
A balloon unfolds the narrow street.
[Chorus]
One trunk, one valve, four types to know,
Edwards and Collett paved the road we follow,
Type Two — the branches part like sisters, hand in hand,
Right arch riding where the left should stand.
Twelve millimeters, ten months in, the strain—
Balloon and pressure widen out the lane,
Sing it once, then sing it twice again,
The label's just the door, the anatomy's the key.
[Verse 3]
Sixty gave a shrug, no pump to hold the chest,
Palliate and pray was all they had to test,
Eighty-five brought conduits, valves of borrowed grace,
Surgeons learning slower than the spiral's pace.
Now the scan resolves in seconds, sharp and flat,
Progress isn't a straight line — it circles back.
[Bridge]
Surgeon says: the borders, the branches, and the arch,
Cardiologist counts the pressures as they march,
Historian reminds us what the decades cost—
Do the classifications still matter, or are they lost?
They matter when they guide the hand about to cut,
They matter less than function, but they're never "just."
Three voices at the table, one child on the chart,
The taxonomy's a language, not the heart.
[Verse 4]
Growth-potential conduits stretching with the years,
Tissue engineered from the patient's own frontiers,
Expandable valves that flex but never fail,
No more re-op every time the child gets tall.
Twelve months, twelve years, the graft will learn to grow,
Type Two truncus — now the story that we know.
[Verse 5]
Somewhere a resident studies the four types twice,
Memorizing Collett's numbers like the roll of dice,
But the mother in the waiting room don't know the name,
She just wants the sternum closed, the fever tame.
Between the textbook and the bedside there's a bridge—
Language built for rounds, not for the ridge
Of a scar that maps a life still being drawn,
Truncus arteriosus, breathing on till dawn.
[Chorus]
One trunk, one valve, four types to know,
Edwards and Collett paved the road we follow,
Type Two — the branches part like sisters, hand in hand,
Right arch riding where the left should stand.
Twelve millimeters, ten months in, the strain—
Balloon and pressure widen out the lane,
Sing it once, then sing it twice again,
The label's just the door, the anatomy's the key.
[Outro]
One trunk becomes a lifetime, chart by chart,
Surgeon, scholar, cardiologist — three lenses, one small heart.
11. One Trunk, Three Branches
[Verse 1]
Two roads, one vessel, single trunk that splits in three,
Type Two Truncus — where the pulmonary branches both agree
to rise together from that shared arterial cone.
Joint written exam, thirty percent, that's the anatomy zone.
Collett and Edwards, Van Praagh's careful hand,
memorize the branching where the great trunk takes its stand.
[Chorus]
Тридцять, сорок, двадцять, десять — рахуй зі мною в лад,
(Thirty, forty, twenty, ten — count it in the stride)
Final assessment, оцінка остання назад,
surgeon or historian, однакова путь —
different roads through one great trunk, до фіналу йдуть.
[Verse 2]
Forty percent — the fork within the corridor:
surgeons draft the operative plan on a real type two, nothing more —
where the conduit sits, how the septum's laid,
while historians write the essay on a landmark paper's trade,
tracing back through Van Praagh's ink, through Collett's early hand,
same weight, same fire, different language, equal stand.
[Verse 3]
Twenty for the seminar, the integrative stage,
stand and speak the pathophysiology, argue page by page.
Present the case in front of peers, cardiologists and scribes,
trace the flow, the mixing, how one vessel still divides.
[Chorus]
Тридцять, сорок, двадцять, десять — рахуй зі мною в лад,
Final assessment, оцінка остання назад,
surgeon or historian, однакова путь —
type two truncus arteriosus — до фіналу йдуть.
[Bridge]
Ten for showing up, for hands upon the bench —
workshop participation closes up the trench.
Не забудь, don't forget, the smallest weight still counts,
кожен відсоток має вагу — every point amounts.
[Verse 4]
So add it plain: thirty, forty, twenty, ten —
written, special, spoken, shown, again and again.
Whichever track you walk, the truncus stays the same:
one vessel, two arteries, one final, weighted name.
[Verse 5]
Think of the infant on the table, chest wide, heart exposed,
one trunk feeding body, lungs, coronaries — the riddle still unclosed.
The resident scribbling notes, the professor at the board,
both are chasing one truth that the embryo once stored:
that nature drew two arteries from a single, common seed,
and every mark we're given traces back to how we read
the echo, the angiogram, the old dissected chart —
knowledge splits like vessels but still shares one beating heart.
Радіологи, хірурги, історики at the door,
рахуємо разом — together we keep the score.
[Bridge 2]
Whether the pen or the scalpel is what you choose to wield,
the truncus doesn't care what paper says you've healed —
it only asks for understanding, deep and true,
Розумієш? Do you understand? — that's all it asks of you.
[Chorus]
Тридцять, сорок, двадцять, десять — рахуй зі мною в лад,
Final assessment, оцінка остання назад,
surgeon or historian, однакова путь —
type two truncus arteriosus — до фіналу йдуть.
[Outro]
Оцінка фінальна... final, and it's done.
One trunk, two futures, measured, weighed, as one.
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