What is a RIMA graft, and when is it typically used in CABG?

• A. Right gastroepiploic artery; only for RBC.
• B. SVG to RCA
• C. LIMA to diagonal
• D. Right internal mammary artery; used as arterial conduit, often to the LAD or additional targets; good long-term patency with similar benefits to LIMA.

Answer: (D)

A Right Internal Mammary Artery graft is an arterial conduit taken from the right side of the chest to bypass blocked coronary arteries. Like the left internal mammary artery, it’s prized for its durability and long-term patency, which helps improve graft longevity.

It’s commonly used when a second arterial conduit is desired in CABG, often to reach targets beyond the LAD or to supplement a LIMA graft. In practice, the RIMA can be placed to the LAD, diagonal, or other arteries depending on the patient’s anatomy, offering durable results similar to the LIMA.

Other options refer to different vessels or configurations (for example, saphenous vein grafts to the RCA or using the LIMA to a diagonal), but they describe different conduits or targets. The distinctive point about the correct choice is that it names the Right Internal Mammary Artery and highlights its role as an arterial conduit with good long-term patency, used to complement the LIMA and reach various targets.