Figure(A):Zoomed apical-5 chamber view shows an over-riding aorta with a perimembranous VSD that is closed by an aneurysmal tricuspid valve leaflet. Figure(B): Color Doppler flow shows left to right shunt across the defect (VSD entry diameter is 9mm) Figure(C): Aortic short axis view shows 2 systolic jets ; one is seen across the defect and the one is seen along regurgitant tricuspid valve. Figure(D): TTE bubble study shows negative contrast inside the right ventricular cavity indicating communicating VSD with the right ventricle (Red arrows). Figure (E): Zoomed mode of the aortic-LVOT junction reveals clear the entry point from the left ventricle and exit point at the right ventricle. Figure (F):En-face viewing of the tricuspid valve from the RV perspective shows an aneurysm of the anterior leaflet closing the VSD