Exhibit 10.23 [ATS MEDICAL LETTERHEAD] November 1st, 2002 Manuel A. Villafana, Chairman ATS Medical, Inc. 3905 Annapolis Lane Minneapolis, MN 55447 Subject: Consulting Agreement Renewal/Extention Dear Manny; In accordance with the terms of the...

                                                                   Exhibit 10.23

[ATS MEDICAL LETTERHEAD]




                               November 1st, 2002

Xxxxxx X. Xxxxxxxxx, Chairman
ATS Medical, Inc.
0000 Xxxxxxxxx Xxxx
Xxxxxxxxxxx, XX  00000

                 Subject: Consulting Agreement Renewal/Extention

Dear Xxxxx;

In accordance with the terms of the Consulting Agreement that we have with you,
we hereby extend the term for an additional one year thru December 31st, 2003.

As always, ATS reserves the right to extend the Agreement on a yearly basis if
mutually agreed upon.

Sincerely yours,
ATS MEDICAL, INC.

/s/ Xxxxxxx X. Xxxx

Xxxxxxx X. Xxxx
President/CEO