What is the most likely diagnosis? 
              
- 79 year-old male with chronic shortness of breath
 
    
                  
              Frontal Chest Radiograph
    Edge-enhanced and Reversed
            
              - Dorsal column stimulator 
 
              - Esophageal Stimulator
 
              - Cavo-splenic shunt 
 
              - Artifact
 
              - Left Ventricular Assist Device
 
              
            Additional Images - Coronal CT reconstructions
             
              
             
            
               
              Additional Images
               
              
              Coronal CT Reconstructions
              
             
            
              
                  Answer:
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                5. Left Ventricular Assist Device
              
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              Left Ventricular Assist Device
              General Considerations
              - Surgically implanted,       mechanical circulatory assist device in patients with severe and medically       refractory heart failure
 
                - Originally, these       devices were used as a bridge to cardiac transplantation
 
                - LVAD are now used as       a permanent alternative to heart transplantation (known as destination       therapy)
 
                - It is estimated that       250,000 patients in US are in refractory heart failure and there are       approximately 2,100 donor hearts available each year
 
              
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