Communication between the left ventricle and right atrium has a reported prevalence of less than 1%. Acquired left ventricular--right atrial shunt is caused by chest trauma or valvular surgery. A case of acquired left ventricular--right atrial shunt after aortic valve surgery is reported. The detection was possible by use of echo-Doppler, color flow imaging, and transesophageal echocardiography. Combined use of these modalities and multiple transducer positions when transthoracic echocardiography is used are recommended to make the diagnosis.