Where is the SVG to the RCA typically located?

• A. Highest on the ascending aorta above the LAD graft
• B. Lowest on the ascending aorta directly above the RCA ostium
• C. Mid ascending aorta near the left coronary ostium
• D. On the aortic arch near the brachiocephalic trunk

Answer: (B)

In CABG using a saphenous vein graft to the right coronary artery, the proximal connection of the graft is placed on the ascending aorta in a position that delivers blood into the RCA downstream. The usual spot is directly above the right coronary ostium. This location provides reliable flow from the aorta into the graft to perfuse the RCA territory and keeps the anastomosis away from the left coronary system or the arch.

Other sites described are not typical for this graft: placing the proximal anastomosis above the LAD graft would favor the left system, placing it near the left coronary ostium targets the left coronary arteries, and the arch near the brachiocephalic trunk is not the standard site for an RCA graft.