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. 2020 May 18;10:8202. doi: 10.1038/s41598-020-65185-9

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Prevention of embolic stroke and successful surgical repair. (a) Ventricular fibrillation was induced using quadripolar catheter immediately after veno-arterial extracorporeal membrane oxygenation apply. (b,c) Echocardiography revealed continuous aortic regurgitant jet suggesting complete reversal of blood flow direction in the thoracic aorta. (d) On-pump, open heart surgical repair of left atrium and esophagus was performed and follow-up endoscopy revealed no fistula. White arrow indicates operation scar. (e) Despite several small-sized embolic lesions, the patient was free of neurologic consequences.