The field of cardiovascular surgery has been relatively stable from 1964 to 1990 where primary advances were in improvements of existing procedures from a morbidity and mortality reduction standpoint. New procedures were introduced but not wholly embraced during this time. The mid 1990's brought an initiation of adoption of new procedures such as “off pump” coronary surgery, robotic, and endoscopic advances. The breadth and depth of the new technologies continue to advance at an ever rapid pace with ever accelerating adoption rates worldwide which in turn then generates even faster technological advancement. This article will strive to give an overview of the technologies and future currently facing the leading cardiovascular surgeons.