Enhanced use of the right internal thoracic artery affords further opp
ortunity for myocardial revascularization using predominantly arterial
conduits. High proximal dissection and routing of the right internal
thoracic artery behind the superior vena cava can sometimes allow addi
tional length to the right internal thoracic artery pedicle to facilit
ate the grafting of posterior and lateral coronary arteries via a less
circuitous, more protected route.