CONGRESS ABSTRACT

Introduction Extra-corporeal-membrane-oxygenation (ECMO) is a frequent rescue treatment sudden cardiac arrest. Many times the causes of the cardiac arrest are unknown, so CT scan is frequently scheduled following ECMO implant to find a possible diagnosis. Considering the constant competitive flow between the patient's native cardiac output and the retrograde flow introduced by the arterial cannula in the femoral artery, artifacts could be generated. Unfortunately, flow artifacts could be difficult to discern from severe pathologic conditions such as pulmonary embolism or acute aortic dissection (AAD). Here we reviewed a particular case of ECMO-patient undergoing acute CTscan showing the CTscan equivalent of Harlequin syndrome, which mimicked an acute aortic dissection.   Case Presentation The patient arrived at the hospital in sudden cardiac arrest. ECMO implantation procedures were initiated, and he underwent an acute contrast-enhanced CT scan. Suspicious of AAD from aortic root (fig 1a-b) was diagnosed following ECMO implantation in cath-lab. The patient was in unstable clinical conditions, so it was decided to stabilize the parameters and clinical conditions and not to operate urgently. In the following days, due to improvement in clinical conditions and a favorable clinical course, ECMO weaning. Follow-up CT scan was carried out, which showed no-signs of AAD (fig 2a-b).   Discussion CTscan equivalent of harlequin syndrome could be a dissection-like image which has to be recognized by experienced radiologist at time of early CT report to avoid potential drastic consequence.