Although rare, acquired Gerbode defect (abnormal communication between left ventricle and right atrium) may result as a complication of myocardial infarction, endocarditis as well as aortic or mitral valve replacement resulting in resistant heart failure secondary to significant left to right shunting. We are reporting the case of a 50-year old lady with repeated aortic valve replacement presenting with resistant heart failure secondary to an acquired Gerbode defect. Management of this defect in these high-risk patients may be challenging and percutaneous closure, if feasible, may represent the best management option.