Facilitated vascular anastomosis in coronary bypass surgery

The goal of truly minimally invasive surgical revascularization with 1-day hospital stays is shared by surgeons, patients, and payors alike. However, accomplishing this will involve doing surgery through more limited-access incisions and working within closed spaces. Suture management in this setting is cumbersome, slow, and unreliable. Facilitated anastomotic techniques and technologies are generally believed to be the vehicle that will ultimately allow us to address this. A considerable amount of time and resources has already been expended by many people and companies in this effort, with early clinical progress now being reported. Much more remains to be done, and other new approaches still need to be investigated. This article provides an overview or snapshot of the work and progress to date with facilitated vascular anastomoses along with some of the challenges that have yet to be solved. The achievement of a predictable, reproducible, and reliable technique to accomplish this will significantly and irrevocably reduce the extent of surgery required to revascularize the heart.