Congenital Aortic Stenosis : The valve may be unicuspid, bicuspid or tricuspid. Rarely it is a dome shaped diaphragm. Uni commissural aortic stenosis produces significant symptoms in infants below one year. Bicuspid valves may be stenotic with commissural fusion early in life but often present later in adult life because of fibrosis and calcification induced by turbulent flow. Rarely, a tricuspid valve with a rudimentary cusp may produce calcific aortic stenosis in elderly either due to congenital abnormality or of rheumatic or degenerative causes.