Methods of implantation for transcatheter atrial sealing skirt, anchor, and tether

A method of endovascularly delivering and implanting a medical assembly for minimally invasively implanting an atrial sealing skirt having a generally cylindrical skirt body and an atrial sealing skirt top brim extending circumferentially around an upper edge of said skirt body in a heart at an atrial sealing skirt deployment site, sealing the top brim against a respective atrial floor of the heart, and anchoring the atrial sealing skirt on an intracardiac wall at an implantation site with an anchor having an anchor screw, anchor cap and delivery cable, and a tether connecting the anchor and the sealing skirt, said medical assembly comprising a removeable anchor delivery system having an anchor delivery guide defining a longitudinally extending lumen and having an anchor delivery rod defining an inner rod lumen, said anchor delivery rod being removably positioned within the anchor delivery guide, and a second delivery system including a second delivery guide defining an inner guide lumen configured for receipt of at least a portion of the tether, the method comprising the steps of:

• removably coupling the delivery cable and the anchor cap and removably coupling the anchor delivery rod and the anchor cap;
• endovascularly introducing the anchor delivery system into the heart;
• advancing a distal end of the anchor delivery guide into the heart, through the deployment site and to the implantation site;
• advancing the anchor delivery rod and contacting the anchor screw against the implantation site;
• manipulating the anchor delivery rod and implanting the anchor into the implantation site to implant the anchor into the intracardiac wall;
• retracting the anchor delivery rod, and leaving the anchor implanted at the implantation site and the anchor delivery cable extending from the anchor cap, through the atrial sealing skirt deployment site and extending externally from the heart;
• endovascularly introducing the second delivery system over the delivery cable secured to the implanted anchor by introducing the second delivery guide which includes the tether having at least one cord extending from a proximal end of the tether and the at least one cord extending within the second delivery guide inner lumen;
• advancing the second delivery system so that the tether couples with the anchor cap;
• and
• locking the tether to said anchor cap.