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We present a case of a 67-year-old woman who was admitted to the hospital due to suspicion of a paravalvular leak around the artificial aortic valve. The patient had undergone the procedure of simultaneous implantation of aortic and mitral mechanical valves 8 years before the current problem: in both the aortic and the mitral position. Carbomedics valves were implanted in order to treat native valve stenosis. The patient complained of dyspnea, reduced physical exercise tolerance and atypical chest pain for 7 months. Transthoracic echocardiography revealed good function of the artificial valves with normal left ventricle ejection fraction, whereas transesophageal echocardiography (TEE) showed leakage (a fistula) in the anterior part of the aortic ring in the direction towards the left atrium.