Left panel shows the two cusps of aortic valve in open position in parasternal short axis view of echocardiography (blue arrows). Right panel shows the eccentricity of aortic valve closure in M-Mode echocardiography (yellow arrow). All these features are suggestive of bicuspid aortic valve, which is a congenital anomaly. Bicuspid aortic valve is a fairly common congenital anomaly while quadricuspid aortic valve is quite rare. A bicuspid aortic valve can be stenotic or regurgitant. In this case there was no significant regurgitation or stenosis.