Figure(A):En-face view of the aortic valve from the aortic perspective shows a unicuspid , unicommissural aortic valve with characteristic ”teardrop” orifice.. Figure(B):Multiplanar reformatting of the AV was used to planimeter of the orifice area (1.1cm2). Figure(C): Continuous wave Doppler AV shows high peak and mean systolic gradients . Figure(D): 2D TOE shows a subaortic ridge (yellow arrow). Figure (E): Zoomed mode of the AV from LVOT perspective confirms the presence of the subaortic ridge extending from the commissure to the cusp edge .(yellow arrow).Figure (F):Zoom mode of the aortic-subaortic region shows an obstructive subaortic ridge