Coronary artery bypass surgery (CABG) has been an established technique for the treatment of severe coronary artery disease for more than 20 years and is one of the most frequently performed surgical procedures in industrialized countries. Continuous technical and pharmacologic refinements in perioperative management, including advances in anesthesia and cardiopulmonary bypass (CPB) techniques (i.e., stop ping the heart and using a heart/lung pump to keep the blood flowing through the body) have improved the results of coronary surgery. However, the trade-off for such advancements is often increased costs and resource utilization. While the results or outcomes of inhospital mortality and morbidity have reached a plateau, an increasing number of "high-risk" patients are being considered for procedures that were previously contraindicated in their situations. Therefore, innovations for alternative methods of surgical myocardial revascularization continue to develop, with the aim of both improving the results of coronary surgery and reducing the use of healthcare resources.