Atrioventricular septal defect with a common valve and intermediate insertion between Rastelli types A and B. (A) The insertion of the anterior leaflets is on the right surface of the ventricular septum below its crest. The left anterior leaflet bridges the ventricular septal defect. The ostium primum (upper asterisk) and the atrioventricular defect (lower asterisk) combine to form the large septal defect. The arrow points to the interchordal spaces. (B) The 4 chamber echocardiographic image shows an insertion similar to that observed in the anatomic specimen (arrow). Abbreviations as before.