[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.
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