Aortic insufficiency with recirculation syndrome can be a difficult diagnosis to make in patients with continuous flow left ventricular assist devices as it is generally underestimated by traditional transthoracic echocardiography. Transesophageal echocardiography can also underestimate aortic insufficiency and requires general anesthesia, which can be prohibitive in some cases. This case study demonstrates a novel use of intracardiac echocardiography to evaluate for and troubleshoot complications associated with continuous flow left ventricular assist devices. Intracardiac echocardiography was able to rule out aortic insufficiency in our patient, thereby preventing unnecessary procedures such as a valvular intervention.