Internal view of the right chambers of a heart shows grade III tethering of the tricuspid septal leaflet. The arrows point to tethering of the posterior leaflet. The flap of the free portion of the septal leaflet can be seen (asterisk) as well as the redundant anterior leaflet with 3 accessory openings. The 4 chamber echocardiographic image shows the same features and the greater size of the atrialized portion of the right ventricle with significant reduction of the functional portion. Abbreviations as before.