Mathew Barzal had a goal and an assist, and Noah Dobson and Simon Holmstrom also scored for the Islanders, who were 3-0-1 in their last four. Bo Horvat had two assists, and Ilya Sorokin finished with 44 saves.
Aho scored in the extra period just after Raanta denied Ryan Pulock’s point-blank shot.
Dobson opened the scoring with 2:20 left in the first period with the teams skating 4-on-4. The defenseman skated in close on Raanta before flipping a backhand past the goalie for his third goal of the season. Dobson leads the Islanders with 10 points (three goals, seven assists).
Holmstrom made it 2-0 with a short-handed goal at 4:11 of the second, completing a give-and-go with Jean-Gabriel Pageau for his third.
Barzal extended the lead to 3-0 with his second goal of the season at 7:46 as his high shot from the right wing eluded Raanta.
It was all Hurricanes after that.
Chatfield broke through just 32 seconds later with his first of the season.
Orlov narrowed the gap to 3-2 with 7:41 remaining in the third when his shot eluded Sorokin for his first with Carolina after signing as a free agent in the offseason.
Kotkaniemi tied the score on the power play with 4:36 left, scoring his fifth from in front as time was about to expire on Scott Mayfield’s hooking penalty.
Hurricanes: Host Buffalo on Tuesday night.
Islanders: Host Minnesota on Tuesday night.