What has been your approach to using contrast enhancement agent in the echo lab in pregnant patients if there is concern for LV thrombus or poor imaging windows for LVEF/valvular disease assessment?   

This is a quote from a recent ACC article: "The use of agitated saline for evaluation of intracardiac shunting is not recommended in the setting of pregnancy. There are no empirical safety data on the use of ultrasound-enhancing agents (perflutren, sulfur hexafluoride) in pregnancy, although data fr...