L.B. is a 62-year-old man with a long history of coronary artery disease and heart failure who has undergone multiple coronary bypass surgeries. He now has an ejection fraction of 25% and intractable ventricular tachycardia despite medical management. Due to the risks of ablation, the team is considering options like hospice care, cardiac transplantation, VAD implantation, or VAD exchange to treat his advanced heart failure. A cardiac catheterization revealed multiple occluded arteries and stenoses. Given his medical history and surgical history, the team must determine the best treatment approach for his condition.