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Immediate post-operative evaluation of patients who have received a left ventricular assist device (LVAD) can be a daunting task. We present a case of a 51-year-old female who developed ventricular tachycardia soon after returning from the operating theater and describe the role transesophageal echocardiogram played in helping prompt urgent and definitive treatment.fatcat:r2vccd2qmneijjw22dz2gl3fjy