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  3. Lesion: Complete Atrioventricular Canal (AV Canal)
  4. View: Subcostal AV valves
  • Complete AV Canal
    • Rastelli Type A subtype of complete balanced AV Canal 
      • Common AV valve en face
      • Anterior superior bridging leaflet with attachments to the crest of the interventricular septum
  • Complete AV Canal
    • Rastelli Type A complete AV canal defect
      • Common AV valve shown en face
      • Attachments of superior bridging leaflet to crest of ventricular septum are noted
  • Rastelli Type A subtype of complete balanced AV canal 
    • Common AV valve en face
    • The anterior superior bridging leaflet of the common AV valve demonstrates attachments to the crest of the interventricular septum
  • Complete AV Canal
    • Rastelli Type B subtype of complete balanced AV canal
      • Common AV valve profiled an face
      • Inlet VSD
      • The anterior bridging leaflet demonstrates attachments fo an anomalous RV papillary muscle on the right side of the ventricular septum 
  • Complete AV Canal
    • Rastelli Type B subtype of complete balanced AV canal
      • Common AV valve profiled an face
      • The anterior bridging leaflet demonstrates attachments fo an anomalous RV papillary muscle on the right side of the ventricular septum 
  • Complete AV Canal
    • Rastelli Type C subtype of complete balanced AV canal
      • Common AV valve profiled an face
      • The anterior leaflet is "free floating" and attached to the anterior papillary muscle with no attachements to the crest of the interventricular septum
  • Complete AV Canal
    • Rastelli Type C subtype of complete balanced AV canal (color Doppler)
      • Common AV valve profiled an face
      • The anterior leaflet is "free floating" and attached to the anterior papillary muscle with no attachements to the crest of the interventricular septum
      • Mild common AV valve regurgitation

Echocardiographic Assessment: Subcotal left anterior oblique (LAO)

  • Inlet VSD
  • Profile common AV valve (en face)
  • Assess AV valve (balanced versus unbalanced, common AV valve versus two discrete orifaces)
  • Rastelli classificaiton?

    • Rastelli Type A: The anterior bridging leaflet demonstrates attachments to the crest of the ventricular septum (most common, 50-70%)

    • Rastelli Type B: The anterior bridging leaflet demonstrates attachments fo an anomalous RV papillary muscle on the RV side of the ventricular septum (least common ~3%)

    • Rastelli Type C: The anterior leaflet is "free floating" and attached to the anterior papillary muscle with no attachements to the crest of the interventricular septum (~30%)

  • Modified echo view
  • Transducer on abdomen just below xyphoid process
  • From this view, rotate tranducer counterclockwise
  • Notch between 2-3 o'clock (left anterior oblique view)
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