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This is the aortic valve in closed position and mitral valve also appears to be closed in position. From the images you do not know whether the mitral valve is really fully closed or almost about to be closed. The VSD is partly overrided by the aorta. Separation between the attachments of the aortic and mitral valve.
We know a small ASD decompresses mitral stenosis, and the combination of ASD and MS, Lutembacher, is a well-known syndrome called Lutembacher. This is to create a small regulatory orifice in the IAS ( A complicated term for a small ASD ) to decompress the LA and reduce pulmonary congestive symptoms. JAMA Cardiol.
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