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Common atrioventricular canal. Patients with Down syndrome commonly have congenital heart disease, and the congenital heart disease often originates from a defect in the endocardial cushions. This defect may manifest as a common atrioventricular canal, a primum atrial septal defect, or a ventricular septal defect. The photograph illustrates a common atrioventricular canal. The defect involves the lower portion of the interatrial septum and the upper portion of the interventricular septum. The arrowhead indicates the cleft anterior leaflet of the mitral valve, a feature that is commonly seen in patients who have this congenital heart defect. Source: Chapter 6. Genetic Disorders, Pathology: The Big Picture Citation: Kemp WL, Burns DK, Brown TG. Pathology: The Big Picture; 2008 Available at: http://mhmedical.com/ Accessed: May 13, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved