Distal anchor apparatus and methods for mitral valve repair

An apparatus, comprising:

• a handle;
• one or more actuators operably coupled to the handle;
• an elongate outer tube projecting from the handle;
• a pusher device defining a lumen and disposed at least partially within the elongate outer tube and the handle;
• a puncture member coupled to the one or more actuators and at least partially disposed within the lumen of the pusher device;
• and
• a tissue anchor disposed in a delivery configuration around a distal portion of the puncture member, the tissue anchor being associated with one or more suture tails that are coupled to the handle and extend through a lumen of the puncture member;
• wherein the one or more actuators are configured to be actuated to cause (1) the puncture member to move distally to an extended position in which the puncture member projects from a distal opening of the elongate outer tube a preset distance, and (2) the pusher device to move distally such that the tissue anchor is pushed distally off of a distal end of the puncture member by a distal end of the pusher device while the puncture member is in the extended position.