This case demonstrates a patient with quadricuspid aortic valve (QAV), which is a rare congenital valvular anomaly wherein there are four cusps, instead of the usual three, in the aortic valve.  In this case, the aortic valve is composed of four equal-sized cusps (type a QAV).  The most common complication of this valvular anomaly is aortic regurgitation due to inadequate closing of the four cusps during systole.