A bi-directional cannula for perfusing blood in two directions. The cannula has a distal opening in fluid communication with a cannula first lumen. The cannula has a secondary opening proximal of the distal opening, and may include a movable tubular extension selectively extendable from the cannula via the secondary opening. The tubular extension may be in fluid connection with the cannula first lumen and/or a cannula second lumen. The tubular extension may have distal and/or side openings, with the openings providing antegrade fluid perfusion. The cannula second lumen may be separate from the first lumen, so that perfusion can be selectively provided to just the cannula distal opening, just the secondary opening/tubular extension, or simultaneously to both the distal opening and secondary opening/tubular extension.