A 
system for performing an end-to-side 
vascular anastomosis including an 
anastomosis device, an application instrument and methods for performing a 
vascular anastomosis. The 
system is applicable for performing an 
anastomosis between a 
vascular graft and the 
ascending aorta in 
coronary artery bypass surgery, particularly in port-access 
CABG surgery. A first aspect of the invention includes a 
vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the 
target vessel wall and a 
coupling member, forming the attachment with the bypass graft vessel. The 
anastomosis is completed by inserting the 
coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the 
coupling member into a one-piece anastomosis staple. A second aspect of the invention includes an anastomotic fitting, having an inner 
flange over which the graft vessel is everted and an outer 
flange which contacts the exterior surface of the 
target vessel. A tailored amount of compression applied by the inner and outer flanges grips the 
target vessel wall and creates a leak-proof seal between the graft vessel and the target vessel. A third aspect of the invention has a 
flange to which the graft vessel attaches, by everting the graft vessel over the flange, and a plurality of staple-like members which attach the flange and the everted end of the graft vessel to the wall of the target vessel to form the anastomosis