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To the Editor: Perflutren cardiac ultrasound agents improve diagnostic accuracy in patients whose imaging is technically difficult.¹ In October 2007, the US Food and Drug Administration issued a health care provider advisory² ("black box warning") regarding use of Definity (perflutren lipid microsphere: formerly Bristol-Myers Squibb Medical Imaging, New York, New York; now Lantheus Medical Imaging, North Billerica, Massachusetts) and Optison (perflutren protein-type A microspheres for injection; GE Healthcare, Princeton, New Jersey). These agents are now contraindicated in patients for whom their clinical use is considerable: those with unstable congestive heart failure, acute coronary syndrome, respiratory failure, and severe emphysema. The advisory was prompted by identification of 4 fatalities secondary to cardiopulmonary events within 30 minutes of perflutren administration and 11 fatalities overall within 12 hours of administration.²

Methods

The echocardiography database at Hennepin County Medical Center (Minneapolis, Minnesota), begun in March 1986, comprises 112 776 echocardiographic studies and includes data on use . . . [Full Text of this Article]

Charles A. Herzog, MD
cherzog@cdrg.org
Echocardiography Laboratory
Hennepin County Medical Center
Minneapolis, Minnesota