Distal anchor apparatus and methods for mitral valve repair

A method for implanting artificial chordae to improve coaptation, the method comprising:

• inserting a first artificial chordae having a first distal anchor disposed at a distal end portion of the first artificial chordae through an apex region of a heart, through a ventricle of the heart, and to a proximal side of a posterior annulus of the mitral valve, the first distal anchor disposed in a delivery configuration;
• puncturing the posterior annulus to define an opening in the posterior annulus, the first artificial chordae extending through the opening so that the first distal anchor is positioned on a distal side of the posterior annulus;
• deploying the first distal anchor so that the first distal anchor is moved to a deployed configuration to secure the first artificial chordae to the posterior annulus;
• anchoring a proximal end portion of the first artificial chordae to the heart at a location that is basal to a true apex of the heart to apply a force on the posterior annulus, the force being directed anteriorly towards the anterior annulus and downward toward the ventricle;
• inserting a second artificial chordae having a second distal anchor disposed at a distal end portion of the second artificial chordae through the apex region of the heart, through the ventricle of the heart, and to a proximal side of a posterior leaflet of the mitral valve, the second distal anchor disposed in a delivery configuration;
• puncturing the posterior leaflet to define an opening in the posterior leaflet, the second artificial chordae extending through the opening so that the second distal anchor is positioned on a distal side of the posterior leaflet;
• deploying the second distal anchor so that it is moved to a deployed configuration to secure the second artificial chordae to the posterior leaflet;
• and
• anchoring a proximal end portion of the second artificial chordae to the heart to apply a force on the posterior leaflet, the force being directed anteriorly towards the anterior leaflet and downward toward the ventricle.