Systems and methods for coupling devices such as a ventricular assist device to vascular tissues, such as a heart. In one version, a method is provided for attaching a device to vascular tissue for fluid flow. The device includes a cannula coupled to a cuff, and the method includes coupling the cuff to the vascular tissue, penetrating the vascular tissue by inserting a penetration device through the cannula, and inserting a first end of the cannula through the cuff and into the vascular tissue.