A 59-year-old man with a history of severe aortic stenosis with transcatheter aortic valve replacement (TAVR) presented with worsening heart failure. Echocardiography showed a fistula between the aorta and the right ventricle with mild to moderate paravalvular regurgitation. He underwent a valve-in-valve TAVR with symptomatic improvement and decreased flow through the fistula.
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