The above parasternal short axis images show a bicuspic aortic valve. The commissure is asymmetric and is almost in an anteroposterior direction. There are only two cusps- a larger right one and a smaller left one. The top figure shows the commissure in the closed position of the valve and the bottom figure shows the orifice. It can be seen that the valve orifice is much less compared to that in a normal tricuspid aortic valve. This patient had mild aortic stenosis.