Assessment of patients with left ventricular assist devices (LVADs) can be challenging, and multiple modalities are sometimes necessary to arrive at the accurate diagnosis. We describe two patients with persistent heart failure symptoms after HeartMate II LVAD placement. After initial evaluation was unrevealing, retrospectively gated computed tomographic angiography (CTA) was used to diagnose partial inflow obstruction, leading to important changes in management. We describe the techniques and role of retrospective gating and discuss functional assessment by CT as well as future applications. © 2013 by the American Society for Artificial Internal.