Devices, systems and methods for establishing a blood flow conduit between a chamber (14) in a heart (15) of a patient and a remote location. A blood inflow cannula (12) having an outer surface and proximal and distal end portions (12b, 12a). The distal end portion (12a) is configured for insertion into the chamber (14) of the heart (15). First and second anchor elements (80, 82) have respective maximum width dimensions extending outwardly from the outer surface of the cannula (12). The first anchor element (80) is positioned more distally than the second anchor element (82) defining a tissue receiving space therebetween. The maximum width dimension of the first anchor element (80) may be larger than the maximum width dimension of the second anchor element (82) in use. The first anchor element (80) is configured to be positioned inside the heart chamber (14) and the second anchor element (82) is configured to be positioned outside the heart chamber (14) with heart tissue held in the tissue receiving space therebetween.