An anastomosis tool includes a handle connected to a tissue effector that may be capable of being oriented in two or more positions relative to the handle. The tissue effector holds a graft vessel having at least one flap defined in at least one end thereof against the side of a target vessel. Actuation of a trigger or other mechanism on the handle causes the tissue effector to deploy one or more connectors into the flaps of the graft vessel and the side of the target vessel, thereby connecting the graft vessel to the target vessel.