Iatrogenic Aorto–Right Ventricular Fistula: A Rare Complication of Transcatheter Valve Implantation

•Aortic fistulas are a rare complication in patients undergoing balloon expandable TAVI.•Subannular calcification and excessive postdilation can cause ARV fistula formation.•Prompt imaging to quantify the shunt allows for planning and management of these cases.•Smaller, hemodynamically stable shunts can be managed conservatively.•Surgical repair is standard, but percutaneous closure is achievable with TEE guidance.