Spontaneous echo contrast mimicking aortic root thrombus in a patient supported with extracorporeal membrane oxygenation.

Aortic root spontaneous echo contrast is a rare but significant finding. We report a 31-year-old female who was placed on venoarterial extracorporeal membrane oxygenation emergently for acute mitral regurgitation secondary to papillary muscle rupture. Following stabilization, subsequent transesophageal echocardiography suggested aortic root thrombus and prompted emergent surgery. However, further inspection with intraoperative transesophageal echocardiography revealed a spontaneous echo contrast which aided us in the intraoperative decision making.