Abstract Most vascular surgical repair procedures, such as vessel anastomoses, requires using suture materials that are mechanically efficient and accepted by the patient’s body. These materials are essentially composed of synthetic polymers, such as polypropylene (Prolene TM ) or polyglactin (Vicryl TM ). However, once implanted in patients, they are recognized as foreign bodies, and the patient’s immune system will degrade, encapsulate, or even expel them. In this study, we developed innovative biological sutures for cardiovascular surgical repairs using Cell-Assembled extracellular Matrix (CAM)-based ribbons. After a mechanical characterization of the CAM-based ribbons, sutures were made with hydrated or twisted/dried ribbons with an initial width of 2 or 3 mm. These biological sutures were mechanically characterized and used to anastomose ex vivo animal aortas. Data showed that our biological sutures display lower permeability and higher burst resistance than standard Prolene TM suture material. In vivo carotid anastomoses realized in sheep demonstrated that our biological sutures are compatible with standard vascular surgery techniques. Echography confirmed the absence of thrombus and perfect homeostasis with no blood leakage was obtained within the first 10 min after closing the anastomosis. Finally, our findings confirmed the effectiveness and clinical relevance of these innovative biological sutures.Read less <