• Aorto-right ventricular fistula is a rare diagnosis and is on the spectrum of aortic periannular rupture. • Multimodality imaging is crucial in identifying aortic periannular rupture, defining its course, and for preprocedural planning. • We describe a case of aorto-right ventricular fistula, which was successfully treated using an Amplazter vascular plug intravenous device (St. Jude Medical) and is to our knowledge the first reported case of using a plugging device for this type of disorder.