“…However, valvar aortic stenosis with associated left ventricular hypertrophy may also be present [136]. Subvalvar aortic stenosis may also be observed in the context of aortic valve insufficiency [137]. Turbulent flow created by the fixed anatomic obstruction is believed to be responsible for gradual thickening of the aortic valve leaflets which may, in turn, contribute to the development of aortic valve insufficiency [134,138].…”