Atrial fistulas are the non-natural and rarely seen connections between the left atrium and ascending aorta. This pathological connection can be classified as anterior or posterior according to its location. It can be distinguished angiographically by the absence of myocardial branches. With the effect of systemic pressure, a tunnel occurs from the congenitally weak area in the aortic structure to the low-pressure atrium. There may be no symptoms in the patients, or serious clinical findings, including those related to congestive heart failure may be seen. Even if aorto-atrial fistulas are asymptomatic or hemodynamically insignificant, they should be treated to prevent possible complications. Closure can be performed with the catheterization method or open-heart surgery when appropriate. In this case report, we would like to share the treatment approach of a 49-year-old male patient who was admitted to our hospital with chest pain and whose angiographic and echocardiographic examinations revealed a tunnel from the aorta to the atrium. An informed consent was obtained from the patient.