Optimising implant angles may be important in reducing PVR. This is significantly more likely to be achieved with AVG rotational angiography.

CEE is a safe investigation in a broad range of indications and clinical scenarios. AR are very rare, mild and transient.

Using the aortic annulus area or circumference to calculate the annular diameter provides different values. Comparing the two methods, a different prosthesis size could have been implanted in 26.7% of patients. In our series the use of circumference-derived diameter resulted in lower incidence of PVAR. The findings of this study may be independent of the imaging modality and may therefore also apply to computed tomography-based aortic annulus measurements, but this needs to be further investigated.

SUMMARY Arthritis in association with sickle cell disease was seen in 37 patients in a 2½/2-year period. Cases of gout and of avascular necrosis of the femoral head were excluded. In 12 patients a non-inflammatory effusion occurred during the course of a painful crisis, in 12 patients an ankle effusion occurred in association with spontaneous development or deterioration of leg ulceration, and in 13 patients there was a group of miscellaneous arthritides. Ankle arthritis with leg ulceration has not been previously recognised, and its association with spontaneous ulceration, which is presumed to have a vaso-occlusive origin, is compatible with ischaemic synovial damage. The aetiology may therefore be similar to that believed to account for effusions in association with the painful crisis.