Cardiac support is a new and promising therapy for refractory heart failure. Only a few previous publications focused on technical implantation of such device. We have developed a new technique that facilitates a consistent and safe implant when the procedure is done without extra-corporeal circulation (ECC). Herein, we report our experience of 60 consecutive CorCap cardiac support device (Acorn Cardiovascular, USA) implantations off-pump for both isolated and combined implantation.