A 15-year-old male with acute decompensated heart failure was referred to our hospital for left ventricular assist device (LVAD) implantation as a bridge to recovery. Despite optimal medication, repetitive LVAD off-pump test findings suggested that his cardiac function had not improved enough to perform LVAD removal. However, his cardiac function significantly improved with cardiac resynchronization therapy (CRT). He underwent LVAD explantation and was successfully discharged from the hospital. We describe the case of an end-stage heart failure patient who underwent successful LVAD removal with CRT. The effect of CRT was definitively evaluated with right heart catheterization during LVAD off-pump test.