Abstract: Vacuum assisted venous drainage (VAVD) is a technique that increases the volume of venous drainage by applying negative pressure in a closed blood reservoir. In cardiac surgery, especially in minimally invasive cardiac surgery and low-weight patients, VAVD technology has been widely used because of its significant advantages of improving venous drainage efficiency, reducing cardiopulmonary bypass (CPB) priming and improving the clarity of the surgical field. This article reviews the basic principles of VAVD technology, its clinical application in cardiac surgery, and its technical advantages, including improving surgical safety and reducing intraoperative complications. In addition, the challenges faced in the practical application of VAVD technology, such as gas embolism risk, blood injury, device complexity, and high operational requirements, are discussed. In order to solve these problems, this article proposes improvement measures and future research directions, so as to further optimize the application of VAVD technology, improve its reliability and safety in cardiac surgery, and promote the widespread application and continuous improvement of VAVD technology in cardiac surgery.