Severe aortic regurgitation from aortic valve perforation in Libman‐Sacks endocarditis: Incremental value of 3D TEE

A 43‐year‐old woman with stroke and systemic lupus erythematosus was found to have severe eccentric aortic regurgitation. Three‐dimensional transesophageal echocardiogram further defined the origin of the regurgitant jet through a perforation in the left coronary cusp next to a mass with a tiny stalk attached to the left coronary cusp.