CECT and coronary angiography in a patient on VA-ECMO. (A) Aortography showing contrast retention in the coronary sinuses, raising suspicion of type A aortic dissection. (B and C) CECT axial images reveal contrast layering in the ascending and descending aorta (white and yellow arrows, respectively) during the arterial phase. (D) CECT axial images demonstrate pseudo-layering in the descending aorta (yellow arrows) during the arterial phase, with the left ventricle appearing non-opacified. CECT, contrast-enhanced computed tomography; VA-ECMO, veno-arterial extracorporeal membrane oxygenation.