Aorto-cardiac fistula etiology, presentation, and management: A systematic review

•Aorto-cardiac fistulae (ACFs) are most commonly caused by iatrogenic or infectious processes.•Patients will commonly present with heart failure, and/or hemodynamic instability.•ACFs are best seen on TEE which has a high sensitivity and specificity.•ACFs are commonly from the aorta to the right atrium or to the pulmonary artery.•Invasive fistula closure appears to be superior to conservative management.