Simultaneous biplane coronary and pulmonary arteriography: A novel technique for defining the course of an anomalous left main coronary artery originating from the right sinus of Valsalva

We present a novel technique employing biplane cineangiography with simultaneous left coronary and pulmonary angiography to define the anomalous course of the left main coronary artery when it originates from the right sinus of Valsalva. These biplane cinearteriograms clearly define the relationship of the left main coronary artery to the great vessels, allowing confident delineation of the interarterial variant from the other, benign variants. We illustrate the advantages of this technique with two cases in which the course of the anomalous left main coronary artery was incorrectly diagnosed using standard coronary arteriography and magnetic resonance imaging.