Tether attachment assembly for epicardial pads and devices and methods of delivery for same

A system, comprising:

• a prosthetic heart valve having a tether extending therefrom and outside a heart when the prosthetic heart valve is disposed within the heart;
• an epicardial pad configured to be disposed outside of the heart to secure the prosthetic heart valve in a desired position within the heart, the epicardial pad defining an opening through which the tether is configured to extend;
• and
• a fixer assembly configured to be coupled to the epicardial pad, the fixer assembly defining a lumen configured to receive a portion of the tether extending from the epicardial pad therethrough, the fixer assembly including a movable portion and being movable between a first configuration in which the moveable portion is disengaged with the tether, and a second configuration in which the movable portion is engaged with the tether, the fixer assembly configured to secure the epicardial pad to the tether to secure the prosthetic heart valve in the desired position within the heart,
• wherein the fixer assembly is expandable and has an inflated condition and a deflated condition,
• wherein upon transition from the deflated condition to the inflated condition, an outer diameter of the fixer assembly remains fixed and an inner diameter of the fixer assembly decreases, the inner diameter at least partially defining the
• lumen.

A system, comprising:

• a prosthetic heart valve having a tether extending therefrom and outside a heart when the prosthetic heart valve is disposed within the heart;
• an epicardial pad configured to be disposed outside of the heart to secure the prosthetic heart valve in a desired position within the heart, the epicardial pad defining an opening through which the tether is configured to extend;
• and
• a fixer assembly configured to be coupled to the epicardial pad, the fixer assembly defining a lumen configured to receive a portion of the tether extending from the epicardial pad therethrough, the fixer assembly including a movable portion and being movable between a first configuration in which the moveable portion is disengaged with the tether, and a second configuration in which the movable portion is engaged with the tether, the fixer assembly configured to secure the epicardial pad to the tether to secure the prosthetic heart valve in the desired position within the heart,
• wherein the fixer assembly includes a proximal engagement portion having a top plate and an intermediate plate, and a distal portion having a bottom plate,
• wherein the intermediate plate defines a curved track, a curved movable portion having a piercing tip and being movably received within the curved track.