Aortic to right ventricular fistula formation after transcatheter aortic valve replacement (TAVR) is a rare complication. We describe the first case of an aorto-RV fistula after TAVR, conservatively managed, in a patient with concomitant aortic stenosis and wild-type transthyretin cardiac amyloidosis. Given that the underlying pathology may have implications, transthyretin cardiac amyloidosis screening in patients undergoing TAVR is warranted.