Patent Publication Number: US-2023132907-A1

Title: Cardiac valve repair devices, and associated methods and systems

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims the benefit of U.S. Provisional Patent Application No. 63/275,907, filed Nov. 4, 2021, and titled “CARDIAC VALVE DEVICES, AND ASSOCIATED METHODS AND SYSTEMS,” which is incorporated herein by reference in its entirety. 
    
    
     TECHNICAL FIELD 
     The present technology is directed to devices, systems, and methods for cardiac valve repair, and more particularly to valve repair devices with coaptation structures. 
     BACKGROUND 
     Proper functioning of the mitral valve can be affected by mitral valve regurgitation, mitral valve prolapse, and/or mitral valve stenosis. Mitral valve regurgitation can occur when the leaflets of the mitral valve fail to coapt into apposition at peak contraction pressures such that blood leaks from the left ventricle into the left atrium. Several structural factors may affect the proper closure of the mitral valve leaflets. For example, an enlarged mitral annulus caused by dilation of heart muscle may prevent proper coaptation of the leaflets during systole. Other conditions involve a stretch or tear in the chordae tendineae—the tendons connecting the papillary muscles to the inferior side of the mitral valve leaflets—which may also affect proper closure of the mitral annulus. A ruptured chordae tendineae, for example, may cause a valve leaflet to prolapse into the left atrium due to inadequate tension on the leaflet. Abnormal backflow can also occur when the papillary muscles are compromised (e.g., due to ischemia) such that the affected papillary muscles do not contract sufficiently to effect proper closure during systole. 
     Mitral valve prolapse can occur when the mitral leaflets abnormally bulge up into the left atrium, which can also lead to mitral valve regurgitation. Normal functioning of the mitral valve may also be affected by mitral valve stenosis, or a narrowing of the mitral valve orifice, which impedes of filling of the left ventricle during diastole. 
     Mitral valve regurgitation is often treated using diuretics and/or vasodilators to reduce the amount of blood flowing back into the left atrium. Other treatment methods, such as surgical approaches (open and intravascular), have also been used to either repair or replace the native mitral valve. For example, cinching or resecting portions of the dilated annulus are typical repair approaches. Cinching of the annulus has been accomplished by implanting annular or peri-annular rings which are generally secured to the annulus or surrounding tissue. Other repair procedures have also involved suturing or clipping of the valve leaflets into partial apposition with one another. Alternatively, more invasive procedures replace the entire valve with mechanical valves or biological tissue. These invasive procedures are conventionally done through large open thoracotomies and are thus very painful, have significant morbidity, and require long recovery periods. 
     However, with many repair and replacement procedures, the durability of the devices or improper sizing of annuloplasty rings or replacement valves may cause complications. Moreover, many of the repair procedures depend upon the skill of the cardiac surgeon since poorly or inaccurately placed sutures may affect the success of procedures. 
     Compared to other cardiac valves, the mitral valve presents unique challenges because portions of the mitral valve annulus have limited radial support from surrounding tissue and the mitral valve has an irregular, unpredictable shape. For example, the anterior wall of the mitral valve is bound by only a thin wall separating the mitral valve annulus from the inferior portion of the aortic outflow tract. As a result, significant radial forces on the mitral valve annulus are not acceptable as they could lead to collapse of the inferior portion of the aortic tract with potentially fatal consequences. Another challenge of the mitral valve anatomy is that the maze of chordae tendineae in the left ventricle makes navigating and positioning a deployment catheter much more difficult compared to other heart valves. Given the difficulties associated with current procedures, there remains the need for simple, effective, and less invasive devices and methods for treating dysfunctional heart valves. Additionally, since it is also difficult to deliver devices to the mitral valve, there also remains the need for effective and less invasive delivery systems to deliver the implantable cardiac devices to the mitral valve. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Many aspects of the present disclosure can be better understood with reference to the following drawings. The components in the drawings are not necessarily to scale. Instead, emphasis is placed on clearly illustrating the principles of the present disclosure. 
         FIGS.  1 A and  1 B  are a top view and a side view, respectively, of an implantable device that can be implanted within a heart of a subject in accordance with embodiments of the present technology. 
         FIGS.  2 A- 2 C  are different side views, and  FIG.  2 D  is a top view, of an implantable device that can be implanted within a heart of a subject in accordance with additional embodiments of the present technology. 
         FIGS.  3 A and  3 B  are a side view and a top view, respectively, of an atrial-fixation member of the implantable device of  FIGS.  2 A- 2 D  in accordance with embodiments of the present technology. 
         FIGS.  4 A and  4 B  are an enlarged side view and an enlarged perspective view of an attachment portion of the atrial-fixation member of  FIGS.  2 A- 2 D  in accordance with embodiments of the present technology. 
         FIG.  5    is a side view of the atrial-fixation member of  FIGS.  2 A- 2 D  including a posterior fabric member in accordance with embodiments of the present technology. 
         FIG.  6    is a side view of a coaptation member of the implantable device of  FIGS.  2 A- 2 D  configured in accordance with embodiments of the present technology. 
         FIG.  7    is an enlarged side view of the coaptation member of  FIGS.  2 A- 2 D  configured in accordance with embodiments of the present technology. 
         FIG.  8 A  is a side view of a clip of the implantable device of  FIGS.  2 A- 2 D  configured in accordance with embodiments of the present technology.  FIG.  8 B  is a side view of the implantable device of  FIGS.  2 A- 2 D  without a coaptation covering over the coaptation member in accordance with embodiments of the present technology. 
         FIG.  9    is an enlarged side view of the implantable device of  FIGS.  2 A- 2 D  in accordance with embodiments of the present technology. 
         FIGS.  10 A and  10 B  are a side view and a top view of an implantable device that can be implanted within a heart of a subject in accordance with additional embodiments of the present technology. 
         FIGS.  11 A and  11 B  are a side view and a top view of an atrial-fixation member of the implantable device of  FIGS.  10 A and  10 B  configured in accordance with embodiments of the present technology. 
         FIG.  12    is a side cross-sectional view of the implantable device of  FIGS.  10 A- 10 B  implanted at a mitral valve in accordance with embodiments of the present technology. 
         FIG.  13    is a top view of an atrial-fixation member configured in accordance with additional embodiments of the present technology. 
         FIGS.  14 A and  14 B  are a side view and a top view of an implantable device that can be implanted within a heart of a subject in accordance with additional embodiments of the present technology. 
         FIGS.  15 A and  15 B  are a side view and a perspective top view of an atrial-fixation member of the implantable device of  FIGS.  14 A and  14 B  configured in accordance with embodiments of the present technology. 
         FIGS.  16 A- 16 C  are side views of a coaptation member of the implantable device of  FIGS.  14 A and  14 B  with a covering removed in accordance with embodiments of the present technology. 
         FIG.  17    is a side cross-sectional view of the implantable device of  FIGS.  14 A- 14 B  implanted at a mitral valve in accordance with embodiments of the present technology. 
         FIG.  18    is a side view of a coaptation member and an associated clip assembly configured in accordance with embodiments of the present technology. 
         FIG.  19 A  is a side view of a clip assembly configured in accordance with additional embodiments of the present technology.  FIG.  19 B  is a perspective side view of the clip assembly of  FIG.  19 A  showing only a back member and an attachment member of the clip assembly in accordance with embodiments of the present technology. 
         FIG.  20    is an enlarged perspective side view of the coaptation member of the implantable device of  FIGS.  14 A and  14 B  including the clip assembly of  FIGS.  19 A and  19 B  in accordance with embodiments of the present technology. 
         FIGS.  21 A- 21 C  are side views illustrating the sequential attachment of a first fabric layer to a clip member of the clip assembly of  FIGS.  19 A and  19 B  in accordance with embodiments of the present technology. 
         FIGS.  22 A and  22 B  are a perspective side view and a side view, respectively, illustrating the sequential attachment of a second fabric layer to the clip member of the clip assembly of  FIGS.  19 A and  19 B  in accordance with embodiments of the present technology. 
     
    
    
     DETAILED DESCRIPTION 
     The present technology is directed to cardiac valve repair devices and associated systems and methods. In some embodiments, for example, cardiac valve repair devices (also referred to herein as “mitral valve repair devices,” “coaptation assist devices,” “implant devices,” and iterations thereof) include a coaptation member (also referred to as a “coaptation structure,” “baffle,” “intravalvular body,” “intermediate structure,” and iterations thereof) configured to be positioned between native valve leaflets of a cardiac valve. The coaptation member can be coupled to an atrial-fixation member (also referred to as a “brim,” “anchoring structure,” “fixation member,” and iterations thereof) that anchors to cardiac tissue within the atrium and/or provides a platform for ingrowth to hold the coaptation member in place. 
     In some embodiments, the coaptation member can comprise an inner portion having a coaptation surface configured to coapt with a first native leaflet (e.g., an anterior leaflet of a mitral valve) during systole and an outer portion configured to displace at least a portion of a second native leaflet (e.g., a posterior leaflet of the mitral valve). The atrial-fixation member can comprise a plurality of interconnected struts having a circumferential U-like shape about a flow axis of the cardiac valve. The interconnected struts can define a brim portion and a pair of connection portions. The atrial-fixation member can extend upward from the coaptation member relative to the flow axis. The connection portions can be coupled to the coaptation member, and the brim portion can be configured to press against cardiac tissue above the first native leaflet proximate to a native valve annulus of the cardiac valve. In some aspects of the present technology, the atrial-fixation member is configured not to press against cardiac tissue above the second native leaflet proximate to the native valve annulus. 
     In some embodiments, the atrial-fixation member can comprise a plurality of interconnected struts having a curved shape about a flow axis of the cardiac valve, and can be connected to the coaptation member via a pair of arm members extending therebetween. The atrial-fixation member can be configured to press against cardiac tissue above the first native leaflet proximate to the native valve annulus of the cardiac valve. The arm members can each have (i) a first portion that extends upward from the coaptation member relative to the flow axis and (ii) a second portion that curves downward toward the atrial-fixation member relative to the flow axis. 
     In some embodiments, a clip assembly can be coupled to the coaptation member and configured to secure the second native leaflet. The clip assembly can include: (i) a back member, (ii) a clip member having an arm portion and a root portion, (iii) a threaded member coupled to the back member, and (iv) an actuation member coupled to the threaded member. The root portion of the clip portion can be pivotably coupled to the back member, and the threaded member can be configured to rotate relative to the back member. The root portion can define a slot, and the actuation member can include a projection extending at least partially into the slot. The threaded member can be actuated to move the clip between an open position used to capture the second native leaflet and a closed position that secures the second native leaflet between the clip member and the coaptation member. More specifically, the threaded member can be rotated (e.g., via a component of an associated delivery system) in a first direction to drive the actuation member in a first direction (e.g., upward) along the threaded member to drive the arm portion to pivot away from the outer portion of the coaptation member toward the open position. Conversely, the threaded member can be rotated in a second direction to drive the actuation member in a second direction (e.g., downward) along the threaded member to drive the arm portion to pivot toward the outer portion of the coaptation member toward the closed position. 
     Specific details of several embodiments of the technology are described below with reference to  FIGS.  1 A- 22 B . Although many of the embodiments are described below with respect to implant devices, systems, and methods for repair of a native mitral valve, other applications and other embodiments in addition to those described herein are within the scope of the technology. For example, the present technology may be used at other target sites, like the tricuspid valve, the pulmonary valve, and/or the aortic valve. Additionally, several other embodiments of the technology can have different configurations, components, or procedures than those described herein, and features of the embodiments shown can be combined with one another. A person of ordinary skill in the art, therefore, will accordingly understand that the technology can have other embodiments with additional elements, or the technology can have other embodiments without several of the features shown and described below with reference to  FIGS.  1 A- 22 B . In some instances, well-known structures and techniques often associated with cardiac implants and prosthetic heart valves have not been shown in detail so as not to obscure the present technology. The terminology used in the description presented below is intended to be interpreted in its broadest reasonable manner, even though it is being used in conjunction with a detailed description of certain specific embodiments of the disclosure. 
     The accompanying Figures depict embodiments of the present technology and are not intended to be limiting of its scope. The sizes of various depicted elements are not necessarily drawn to scale, and these various elements can be arbitrarily enlarged to improve legibility. Component details can be abstracted in the Figures to exclude details such as position of components and certain precise connections between such components when such details are unnecessary for a complete understanding of how to make and use the present technology. Many of the details, dimensions, angles, and other features shown in the Figures are merely illustrative of particular embodiments of the disclosure. Accordingly, other embodiments can have other details, dimensions, angles, and features without departing from the spirit or scope of the present technology. 
     With regard to the terms “distal” and “proximal” within this description, unless otherwise specified, the terms can reference a relative position of the portions of a catheter subsystem with reference to an operator and/or a location in the vasculature. Also, as used herein, the designations “rearward,” “forward,” “upward,” “downward,” etc., are not meant to limit the referenced component to use in a specific orientation. It will be appreciated that such designations refer to the orientation of the referenced component as illustrated in the Figures; the systems of the present technology can be used in any orientation suitable to the user. 
     With regard to the terms “distal” and “proximal” within this description, unless otherwise specified, the terms can reference a relative position of the portions of a valve repair device and/or an associated delivery device with respect to an operator and/or a location in the vasculature or heart. For example, in referring to a delivery catheter suitable to deliver and position various valve repair devices described herein, “proximal” can refer to a position closer to the operator of the device or an incision into the vasculature, and “distal” can refer to a position that is more distant from the operator of the device or further from the incision along the vasculature (e.g., the end of the catheter). With respect to a heart valve repair device, the terms “proximal” and “distal” can refer to portions of the device relative to the native annulus. For example, “proximal” can refer to an upstream portion of the device spaced apart from the native annulus, and “distal” can refer to a downstream position at or proximate to the native annulus. 
     Further, as used herein, the designations “forward,” “rearward,” “upward,” “downward,” “top,” “bottom,” etc., are not meant to limit the referenced component to use in a specific orientation. It will be appreciated that such designations refer to the orientation of the referenced component as illustrated in the Figures. However, the systems of the present technology can be used in any orientation suitable to the user. 
       FIGS.  1 A and  1 B  are a top view and a side view, respectively, of an implantable device  100  that can be implanted within a heart of a subject (e.g., a human patient) in accordance with embodiments of the present technology. Referring to  FIGS.  1 A and  1 B  together, in the illustrated embodiment the implantable device  100  is a valve repair device having an atrial-fixation member  102  (also referred to as an “anchoring member” or a “brim”) and a coaptation member  104  (also referred to as a “baffle”) extending from the atrial-fixation member  102  in a downstream direction. The atrial-fixation member  102  is configured to anchor the implantable device  100  to cardiac tissue proximate to a native mitral valve annulus and position the coaptation member  104  at a desired location with respect to the native valve anatomy of the heart. The coaptation member  104  is configured to displace at least a portion of one or more native leaflets of a cardiac valve and create a prosthetic coaptation surface for at least a portion of one or more of the other native leaflets of the cardiac valve. For example, when the implantable device  100  is deployed across the mitral valve annulus, the coaptation member  104  may extend in front of a central portion of the posterior leaflet (i.e., P 2  of the posterior leaflet), pushing the posterior leaflet back toward the ventricular wall, such that the coaptation member  104  is positioned to coapt with the anterior leaflet during systole. The implantable device  100  is configured relative to a flow axis VA ( FIG.  1 B ) in the direction of blood flow from the atrium to the ventricle and a transverse axis HA ( FIG.  1 A ) at an angle (e.g., orthogonal) to the flow axis VA. The implantable device  100  has a posterior side portion P (e.g., a first side portion), an anterior side portion A (e.g., a second side portion), a superior end portion S (e.g., a first end portion), and an inferior end portion I (e.g., a second end portion). 
     In some embodiments, the implantable device  100  can include some features generally similar or identical to the implantable devices described in (i) U.S. patent application Ser. No. 16/044,447, titled “PROSTHETIC LEAFLET DEVICE,” and filed Jul. 24, 2018, (ii) International Patent Application No. PCT/US2018/061126, titled “LEAFLET EXTENSION FOR CARDIAC VALVE LEAFLET,” and filed Nov. 14, 2018, (iii) U.S. patent application Ser. No. 16/745,246, titled “IMPLANTABLE COAPTATION ASSIST DEVICES WITH SENSORS AND ASSOCIATED SYSTEMS AND METHODS,” and filed Jan. 16, 2020, (iv) U.S. patent application Ser. No. 16/817,464, titled “CARDIAC VALVE REPAIR DEVICES WITH ANNULOPLASTY FEATURES AND ASSOCIATED SYSTEMS AND METHODS,” and filed Mar. 12, 2020, (v) U.S. patent application Ser. No. 17/027,681, titled “VALVE REPAIR DEVICES WITH COAPTATION STRUCTURES AND MULTIPLE LEAFLET CAPTURE CLIPS,” and filed Sep. 21, 2020, and/or (vi) U.S. patent application Ser. No. 17/184,113, titled “DELIVERY SYSTEMS FOR CARDIAC VALVE DEVICES, AND ASSOCIATED METHODS OF OPERATION,” and filed Mar. 5, 2021, each of which are incorporated herein by reference in their entirety. Any of several prosthetic valve repair or replacement devices could similarly be used with delivery systems in accordance with the present technology, including complete mitral valve replacement devices. And, in addition to mitral valve devices, other valve repair or replacement devices could be delivered to the tricuspid, aortic, and pulmonic valves using delivery systems in accordance with the present invention. 
     The atrial-fixation member  102  can be formed of a mesh, such as a braid or laser-cut stent-like structure, including a plurality of interconnected wires or struts  106  which together define a plurality of openings or cells  108  (e.g., diamond-shaped openings) arranged in one or more rows. The struts  106  can be configured to self-expand from a collapsed delivery state (not shown) to an expanded deployed state shown in  FIGS.  1 A and  1 B . The struts  106  can be formed of any biocompatible material such as, for example, stainless steel, nickel-titanium alloys (e.g., nitinol), and/or other suitable stent materials. The atrial-fixation member  102  can have a generally circular, oval, or D-like shape in the deployed state and define an open central lumen  111  (also referred to as an “opening”) that allows blood to pass therethrough along the flow axis VA. In the illustrated embodiment, the atrial-fixation member  102  extends entirely circumferentially about the flow axis VA. When the implantable device  100  is configured to repair a native mitral valve, the atrial-fixation member  102  can be shaped to conform to the walls of the left atrium just above the mitral annulus to secure the implantable device  100  to the supra-annular tissue. After a period of time post-implantation (e.g., 3 days, 2 weeks, 1 month, 2 months), the atrial-fixation member  102  or portions thereof become covered by a layer of tissue, and this tissue ingrowth adheres the implantable device  100  permanently to the atrial wall. In some embodiments, as described in greater detail below with reference to  FIGS.  10 A- 17   , the atrial-fixation member  102  has a U-like or other shape that does not extend fully around the circumference of the native valve. In some embodiments, the atrial-fixation member  102  may also or alternatively include one or more portions that press against sub-annular tissue to provide sub-annular device fixation. 
     In some embodiments, the atrial-fixation member  102  can include connectors  105  that are configured (e.g., sized, shaped, and/or positioned) to engage with a mating feature on the delivery system, such as any of the mating features described and illustrated in U.S. patent application Ser. No. 17/184,113, titled “DELIVERY SYSTEMS FOR CARDIAC VALVE DEVICES, AND ASSOCIATED METHODS OF OPERATION,” and filed Mar. 5, 2021, which is incorporated herein by reference in its entirety. As shown in  FIG.  1 B , for example, the connectors  105  can extend from the struts  106  such that the connectors  105  are positioned near or at the superior end portion S of the implantable device  100 . In some embodiments, the atrial-fixation member  102  includes one or more eyelets  107  configured to receive one or more tendons that aids in packing (e.g., compressing), delivering, orienting, and/or retrieving the implantable device  100 . For example, the tendons can help facilitate cinching (e.g., radially compressing) of the atrial-fixation member  102 . The eyelets  107  can be metal portions of the atrial-fixation member  102 , or can be separate filaments/wires forming loops and attached to the atrial-fixation member  102 . 
     As shown in  FIGS.  1 A and  1 B , the coaptation member  104  extends away from a downstream end portion of the atrial-fixation member  102  along the flow axis VA and at least a portion of the coaptation member  104  extends radially inward from the atrial-fixation member  102  into the central lumen  111  to approximate a closed position of a native leaflet. The coaptation member  104  can be substantially stationary (e.g., little to no movement) during cardiac cycles such that the position of the coaptation member  104  relative to the atrial-fixation member  102  is at least substantially fixed in the deployed state. Thus, unlike native leaflets that move back and forth to open and close the native valve, the coaptation member  104  remains stationary during diastole and systole. 
     The coaptation member  104  can have an anterior portion  112  ( FIG.  1 B ) with a smooth, atraumatic surface for coapting with at least a portion of one or more native leaflets and a posterior portion  114  ( FIG.  1 B ) configured to displace and, optionally, engage at least a portion of another native leaflet. The coaptation member  104  can be made from a plurality of struts that form a basket-like or frame-like structure (e.g., a mesh structure, a laser cut stent frame) with an at least partially hollow interior and a covering (e.g., a fabric) extending over at least a portion of the struts to provide a smooth suitable surface for coaptation at the anterior portion  112 . The covering may also extend over the struts along the posterior portion  114  and between the anterior and posterior portions  112 ,  114  in a manner that forms lateral sidewalls. The atrial-fixation member  104  or portions thereof can be integral with the atrial-fixation member  102  such that, for example, the coaptation member  104  is manufactured from the same frame including the struts  106 . In other embodiments, the atrial-fixation member  104  can be a separate structure that is connected to a portion of the atrial-fixation member  102  during manufacturing. In some embodiments, the atrial-fixation member  104  can include a biocompatible foam which is attached to the structure of the atrial-fixation member  104  and/or to the atrial-fixation member  102 . 
     In the illustrated embodiment, the atrial-fixation member  104  further includes a normally-closed clip  109  (obscured in  FIG.  1 A ) depending from its posterior surface which can be opened to extend behind the native leaflet the coaptation member  104  displaces. The clip  109  may grasp the native leaflet and/or engage sub-annular cardiac tissue for sub-annular stabilization of the implantable device  100 . In some embodiments, for example, the clip  109  reaches under the central portion (i.e., P 2 ) of the posterior leaflet up to the sub-annular space. A tendon (made of suture or nitinol wire) can actuate the clip  109  by way of a lever attached to the clip  109 . The lever may be a nitinol wire or laser cut nitinol or Co-Cr sheet. 
     As shown in  FIG.  1 A , the atrial-fixation member  104  can further include a delivery attachment member  103  (shown in broken lines) positioned within the hollow interior of the atrial-fixation member  104 . The delivery attachment member  103  can be a threaded nut or other type of connector configured to mate with a corresponding portion (e.g., a screw) of the delivery system, such as such as portions of the delivery systems described and illustrated in U.S. patent application Ser. No. 17/184,113, titled “DELIVERY SYSTEMS FOR CARDIAC VALVE DEVICES, AND ASSOCIATED METHODS OF OPERATION,” and filed Mar. 5, 2021, which is incorporated herein by reference in its entirety. In some embodiments, the delivery attachment member  103  is accessible via a flap or opening  101  ( FIG.  1 A ) formed in the atrial-fixation member  104  (e.g., in portion of the baffle facing the superior end portion S of the implantable device  100 ). 
     The implantable device  100  may be inserted via a femoral vein sheath to traverse the inferior vena cava to the right atrium. The implantable device  100  is then inserted into the left atrium via a puncture of the interatrial septum. In several applications, the implantable device  100  is delivered to a target location within the mitral valve to function properly. This means appropriate positioning along the flow axis VA, correct radial positioning relative to the central axis of the valve, correct rotational orientation to specific landmarks such as the middle (P 2 ) portion of the native posterior leaflet, and correct angular positioning relative to the flow axis and the transverse axis. In some embodiments, the implantable device  100  may also be repositioned during the delivery process to, for example, correct for misalignment or inappropriate positioning. During deployment and release of the implantable device  100 , the delivery system can retain the implantable device  100  in a stationary position at the desired location and in the desired orientation relative to the native valve. Furthermore, the delivery system may be configured to allow the implantable device  100  to be re-sheathed, repositioned, and/or removed before being released from the delivery system. Delivery systems of the present technology can achieve all the above-mentioned advantages in a user-friendly system. Additionally, several embodiments of delivery systems in accordance with the present technology have a small overall diameter, such as approximately 15 to 30 French. 
       FIGS.  2 A- 2 C  are different side views (e.g., an anterior-posterior side view, an anterior or commissure-commissure side view, and a posterior side view, respectively) and  FIG.  2 D  is a top view (e.g., an en face view) of an implantable device  200  that can be implanted within a heart of a subject (e.g., a human patient) in accordance with embodiments of the present technology. The implantable device  200  can include some features that are at least generally similar in structure and function, or identical in structure and function, to the corresponding features of the implantable device  100  described in detail above with reference to  FIGS.  1 A and  1 B , and can operate in a generally similar or identical manner to the implantable device shown in  FIGS.  1 A and  1 B . 
     For example, referring to  FIGS.  2 A- 2 D , in the illustrated embodiment the implantable device  200  is a valve repair device having an atrial-fixation member  202  and a coaptation member  204  extending from the atrial-fixation member  202  in a downstream direction. The atrial-fixation member  202  is configured to anchor the implantable device  200  to cardiac tissue proximate to a native mitral valve annulus and position the coaptation member  204  at a desired location with respect to the native valve anatomy of the heart. The implantable device  200  is designed to eliminate regurgitation by restoring physiologic coaptation in a diseased mitral valve. The coaptation member  204  can be covered in a covering of biocompatible material (e.g., expanded polytetrafluoroethylene (ePTFE)) and shaped (e.g., contoured) to fill a regurgitant orifice of the mitral valve from the posterior side and provide a new coaptation surface for the native leaflets of the mitral valve. The atrial-fixation member  202  can be flexible and can provide additional fixation and supra-annular stabilization. In the illustrated embodiment, the implantable device  200  further includes a posterior clip  209  (obscured in  FIGS.  2 B and  2 D ) that can orient the implantable device  200  and provide sub-annular fixation. 
     The implantable device  200  is configured relative to a flow axis VA ( FIG.  2 A ) in the direction of blood flow from the atrium to the ventricle and a transverse axis HA ( FIG.  2 D ) at an angle (e.g., orthogonal) to the flow axis VA. As shown in  FIG.  2 A , the implantable device  100  has a posterior side portion P (e.g., a first side portion), an anterior side portion A (e.g., a second side portion), a superior end portion S (e.g., a first end portion), and an inferior end portion I (e.g., a second end portion). 
     Referring to  FIG.  2 A , the atrial-fixation member  202  can be formed of a mesh, such as a braid or laser-cut stent-like structure, including a plurality of interconnected wires or struts  206  which together define a plurality of openings or cells  208  (e.g., diamond-shaped openings) arranged in one or more rows. The struts  206  can be configured to self-expand from a collapsed delivery state (not shown) to an expanded deployed state shown in  FIGS.  2 A and  2 B . 
     Referring to  FIGS.  2 A- 2 C , the atrial-fixation member  202  can include fixation features in the form of cleats. For example, the atrial-fixation member  202  can include upward facing anterior cleats  215   a  (e.g., nine upward facing anterior cleats) and upward facing posterior cleats  215   b  (e.g., four upward facing posterior cleats) to inhibit or even prevent migration of the implantable device  200  into the left atrium. Similarly, the atrial-fixation member  202  can include downward facing posterior cleats  215   c  (e.g., four downward facing posterior cleats) to inhibit or even prevent slipping of the implantable device  200  into the left atrium. In some embodiments, the downward facing posterior cleats  215   c  can originate from (e.g., extend from) the coaptation member  204 . 
     Referring to  FIGS.  2 A- 2 D , the atrial-fixation member  202  can include anterior connectors  205   a  (e.g., tab features) and posterior connectors  205   b  that are configured (e.g., sized, shaped, and/or positioned) to engage with a mating feature on an associated delivery system, such as any of the mating features described and illustrated in U.S. patent application Ser. No. 17/184,113, titled “DELIVERY SYSTEMS FOR CARDIAC VALVE DEVICES, AND ASSOCIATED METHODS OF OPERATION,” and filed Mar. 5, 2021, which is incorporated herein by reference in its entirety. The connectors  205  can be extend from the struts  206  such that the connectors  205  are positioned at or near the superior end portion S ( FIG.  2 A ) of the implantable device  200 . In some embodiments, as best seen in  FIG.  2 A , the posterior connectors  205   b  are shorter than the anterior connectors  205   a  to facilitate their release from the delivery system first. The longer anterior connectors  205   a  facilitate their release after the posterior connectors  205   b . The atrial-fixation member  202  can include four each of the posterior connectors  205   b  and the anterior connectors  205   a , or a different number. 
       FIGS.  3 A and  3 B  are a side view and a top view, respectively, of the atrial-fixation member  202  of the implantable device  200  in accordance with embodiments of the present technology. Referring to  FIGS.  3 A and  3 B , the atrial-fixation member  202  includes an atrial-fixation portion  320  and an attachment portion  321  (e.g., a “brim-baffle extension”) extending downstream from the atrial-fixation portion  320  for connection to the coaptation member  204  ( FIGS.  2 A- 2 D ). The atrial-fixation member  202  can be made by shaping a tubular nitinol stent. The atrial-fixation portion  320  can have a 16-column diamond stent pattern (e.g., including 16 columns of the openings  208  arranged circumferentially about the flow axis VA) that extends entirely circumferentially about the flow axis VA. In other embodiments, the atrial-fixation member  202  can have other configurations and/or another number of columns. In some embodiments, the struts  206  have a width from about 0.013-0.017 inch and the struts  206  are electropolished to have a final thickness of about 0.017 inch. Referring to  FIG.  3 A , the attachment portion  321  can have a jog  322  to facilitate better posterior fixation and minimize the area of the coaptation member  204  ( FIGS.  2 A- 2 D ) while still achieving required protrusion of the coaptation member  204  for coaptation with an opposing native leaflet and/or to avoid interference with portions of the subannular native anatomy. 
     In some embodiments, the attachment portion  321  can include one or more features configured to be secured to an associated delivery system.  FIGS.  4 A and  4 B , for example, are an enlarged side view and an enlarged perspective view of the attachment portion  321  of the atrial-fixation member  202  in accordance with embodiments of the present technology. Referring to  FIGS.  4 A and  4 B , the attachment portion  421  can include a nut  423  (e.g., a M 1  nut) secured thereto (e.g., via a rivet  424  shown in  FIG.  4 B ) to provide a feature for attachment of the attachment portion  321  and coaptation member  204  ( FIGS.  2 A- 2 D ) to the delivery system. 
     Referring to  FIGS.  2 A- 2 D , the implantable device  200  can include one or more portions of fabric attached to the atrial-fixation member  202  to facilitate long term tissue ingrowth into the structure of the atrial-fixation member  202 . For example, in the illustrated embodiment the implantable device  200  includes an anterior fabric member  225  attached along a portion of the anterior side portion A ( FIG.  2 A ) of the atrial-fixation member  202  and a posterior fabric member  226  attached along a portion of the posterior side portion P ( FIG.  2 A ) of the of the atrial-fixation member  202  (e.g., proximate and/or adjacent to the coaptation member  204 ). The fabric members  225 ,  226  can comprise polyethylene terephthalate (PET) and/or another suitable material that facilitates long term tissue ingrowth, and can be secured to the atrial-fixation member  202  via sutures and/or other suitable fasteners. In some embodiments, the posterior fabric member  226  extends along the attachment portion  321  ( FIGS.  3 A and  3 B ) of the atrial-fixation member  202  behind the clip  209  to facilitate long term tissue ingrowth into the structure under the clip  209 . For example,  FIG.  5    is a side view of the atrial-fixation member  202  including the posterior fabric member  226  in accordance with embodiments of the present technology. In the illustrated embodiment, the posterior fabric member  226  extends substantially along/over the attachment portion  321  and at least partially along the atrial-fixation portion  320 . 
       FIG.  6    is a side view of the coaptation member  204  of the implantable device  200  configured in accordance with embodiments of the present technology. The coaptation member  204  can be formed of a mesh, such as a braid or laser-cut stent-like structure, including a plurality of interconnected wires or struts  630  which together define a plurality of openings or cells  632 . The struts  630  can be configured to self-expand from a collapsed delivery state (not shown) to an expanded deployed state shown in  FIGS.  2 A- 2 D . The coaptation member  204  can be made from a laser cut nitinol flat sheet and the struts  630  can have a thickness of between about 0.008-0.15 inch (e.g., about 0.012 inch). 
     In the illustrated embodiment, the coaptation member  204  includes an atrial portion  633  and a coaptation portion  634  extending downstream from the atrial portion  633 . The atrial portion  633  can have a diamond stent pattern that generally matches the diamond stent pattern of the atrial-fixation portion  320  ( FIGS.  3 A and  3 B ) of the atrial-fixation member  202 . The coaptation portion  634  is configured to define an at least partially hollow interior space when the implantable device  200  is in the deployed state. In the illustrated embodiment, the downward facing posterior cleats  215   c  extend from the atrial portion  633 . Referring to  FIGS.  2 A- 3 B  and  FIG.  6   , the atrial portion  633  of the coaptation member  204  can be secured to the atrial-fixation portion  320  of the atrial-fixation member  202  via, for example, sutures  235  shown in  FIGS.  2 A- 2 D . Specifically, the atrial portion  633  is best seen secured to the atrial-fixation member  202  in  FIGS.  2 A and  2 C . The sutures  235  can be formed from ultra-high molecular weight polyethylene (UHMWPE) material and/or other suitably strong, biocompatible, and durable materials. In the illustrated embodiment, the diamond stent patterns of the atrial-fixation portion  320  and the atrial portion  633  are aligned such that the struts  206 ,  630 , respectively, are adjacent one another and secured together via the sutures  235 . The atrial portion  633  of the coaptation member can include nine of the diamond openings  632  such that the atrial portion  633  extends only partially about the atrial-fixation member  233  (e.g., proximate the posterior side portion P), or another number of the diamond openings  632 . In some embodiments the coaptation portion  634  of the coaptation member  204  is secured to the attachment portion  221  of the atrial-fixation member  202  via suturing and/or another attachment technique. 
     The coaptation portion  634  of the coaptation member  204  and the attachment portion  221  of the atrial-fixation member  202  can be covered with a coaptation covering, such a polyurethane (PU) foam and/or fabric layer to provide an atraumatic coaptation surface. For example,  FIG.  7    is an enlarged side view of the coaptation member  204  configured in accordance with embodiments of the present technology. In the illustrated embodiment, a foam  736  is secured to the anterior portion of the coaptation portion  634  via sutures  737 . The foam  736  can comprise a 1-millimeter-thick PU foam and the sutures  737  can be UHMWPE sutures and/or other sutures. Additionally referring to  FIGS.  2 A- 2 D , the foam  736  and the coaptation portion  634  can further be covered with a fabric layer  238 , such as an ePTFE fabric having a thickness of about 0.6 millimeter. The foam  736  and the fabric layer  238  can together comprise a coaptation covering that provides an atraumatic coaptation surface. Referring to  FIG.  2 D , the fabric layer  238  can comprise a slit  239  at a superior (e.g., top) portion of the coaptation member  204  to allow for one or more components (e.g., a baffle screw, core plug, clip tendon) of an associated delivery system to attach to the coaptation member  204 . For example, a portion of the clip  209  ( FIGS.  2 A and  2 C ) and the nut  423  ( FIGS.  4 A and  4 B ) can be accessed via the slit  239 . The slit  239  can be configured to close after the coaptation member  204  is detached from the associated delivery system. 
     Referring to  FIGS.  2 A and  2 C , the clip  209  includes a root  240  and an arm  241  extending from the root  240 .  FIG.  8 A  is a side view of the clip  209  configured in accordance with embodiments of the present technology. In the illustrated embodiment, the clip  209  further includes a back  842  extending from the root  240  and a lever  843  that facilitates actuation of the arm  241 . The clip  209  can be made be made from a laser cut nitinol tube.  FIG.  8 B  is a side view of the implantable device  200  without a coaptation covering (e.g., the foam  736  and fabric layer  238  shown in  FIGS.  7  and  2 A- 2 D , respectively) over the coaptation member  204  in accordance with embodiments of the present technology. Referring to  FIGS.  8 A and  8 B , the back  842  of the clip  209  can be secured to the posterior side of the coaptation member  204  via, for example, suturing. A clip tendon suture  844  (e.g., a UHMWPE suture;  FIG.  8 B ) can be attached to the lever  843  (e.g., at an attachment point  845  shown in  FIG.  8 A ) for actuating the arm  241 . The clip tendon suture  844  can be coupled to a component of an associated delivery system during delivery for actuating the clip  209 . In some embodiments, during implantation of the implantable device  200 , the clip  209  can be attached to the posterior back of the coaptation member  204  using the clip tendon suture  844 . Referring to  FIG.  2 C , in some embodiments the clip  209  is at least partially covered with fabric  246  (e.g., PTFE and/or ePTFE) to promote tissue ingrowth into the structure for long term fixation. For example, the root  240  can be layered with the fabric  246  to provide for atraumatic interaction with the posterior leaflet free edge. 
     Referring again to  FIGS.  2 A- 2 D , the implantable device  200  can include features for receiving a removable cinching line for cinching the implantable device  200 . In some aspects of the present technology, cinching allows for a reduction of the profile of the implantable device  200  to facilitate packing into a sleeve of an associated delivery system and/or for repositioning of the implantable device  200  after uncinching in the left atrium. For example, as best seen in  FIGS.  2 A  and  2 B, the implantable device  200  can include multiple loops  247  (e.g., UHMWPE suture loops) formed of suture and attached to an anterior portion of the atrial-fixation member  202 . In the illustrated embodiment, the implantable device  200  includes twelve of the loops  247  and individual ones of the loops  247  are coupled to corresponding middle nodes of the diamond stent pattern of the atrial-fixation portion  320  ( FIGS.  3 A and  3 B ). As best seen in  FIG.  2 C , the implantable device  200  can further include multiple eyelets  248  formed in corresponding ones of the downward facing posterior cleats  215   c .  FIG.  9    is an enlarged side view of the implantable device  200  in accordance with embodiments of the present technology and further illustrating the eyelets  248  in the downward facing posterior cleats  215   c . In the illustrated embodiment, the implantable device  200  can include four of the eyelets  248 . In some embodiments, eyelets can additionally or alternatively be formed in the upward facing posterior cleats  215   b  for receiving a cinching line. As best seen in  FIG.  2 D , the implantable device  200  can further include multiple guide loops  249  (e.g., UHMWPE suture loops) connected to the posterior portion of the atrial-fixation member  202  inward of the posterior fabric member  226 . 
     Referring to  FIGS.  2 A- 2 D , one or more cinching lines can traverse through the loops  247 , the eyelets  248 , and/or the guide loops  249  for cinching the implantable device  200 . A cinching line extending through the loops  247  can cinch the anterior portion of the atrial-fixation member  202 , the same or a different cinching line extending through the eyelets  248  can cinch the posterior portion of the atrial-fixation member  202  and radially pull in the downward facing posterior cleats  215   c  (and/or the upward facing posterior cleats  215   b ), and the same or a different cinching line extending through the guide loops  249  can allow for the posterior cleats  215   b - c  to be biased and/or pulled in radially. In some aspects of the present technology, this can inhibit or even prevent the cleats  215  from interacting with the sleeve of an associated delivery system during unsheathing. 
       FIGS.  10 A and  10 B  are a side view (e.g., an anterior-posterior side view) and a top view (e.g., an en face view) of an implantable device  1000  that can be implanted within a heart of a subject (e.g., a human patient) in accordance with embodiments of the present technology. The implantable device  1000  can include some features that are at least generally similar in structure and function, or identical in structure and function, to the corresponding features of the implantable device  100  and/or the implantable device  200  described in detail above with reference to  FIGS.  1 A- 9   , and can operate in a generally similar or identical manner to the implantable devices shown in  FIGS.  1 A- 9   . 
     For example, referring to  FIGS.  10 A and  10 B , in the illustrated embodiment the implantable device  1000  is a valve repair device having an atrial-fixation member  1002  (also referred to as an “anterior brim,” an “anterior-only brim,” an “anterior anchoring member” or a “suprannular anchoring member”) and a coaptation member  1004  extending from the atrial-fixation member  1002  in a downstream direction. The atrial-fixation member  1002  is configured to anchor the implantable device  1000  to cardiac tissue proximate to a native mitral valve annulus and position the coaptation member  1004  at a desired location with respect to the native valve anatomy of the heart. The implantable device  1000  is designed to eliminate regurgitation by restoring physiologic coaptation in a diseased mitral valve. The coaptation member  1004  can be covered in a biocompatible material (e.g., polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE)) and shaped (e.g., contoured) to fill a regurgitant orifice of the mitral valve from the posterior side and provide a new coaptation surface for the native leaflets of the mitral valve. The atrial-fixation member  1002  can be flexible and can provide additional fixation and supra-annular stabilization. In the illustrated embodiment, the implantable device  1000  further includes a posterior clip  1009  (obscured in  FIG.  10 B ) that can orient the implantable device  1000  and provide sub-annular fixation. 
     The implantable device  1000  is configured relative to a flow axis VA ( FIG.  10 A ) in the direction of blood flow from the atrium to the ventricle and a transverse axis HA ( FIG.  10 B ) at an angle (e.g., orthogonal) to the flow axis VA. As shown in  FIG.  10 A , the implantable device  100  has a posterior side portion P (e.g., a first side portion), an anterior side portion A (e.g., a second side portion), a superior end portion S (e.g., a first end portion), and an inferior end portion I (e.g., a second end portion). 
     In the illustrated embodiment, the atrial-fixation member  1002  comprises a brim member  1050  at the anterior side portion A of the implantable device  1000  and arm members  1052  (including an individually identified first arm member  1052   a  and a second arm member  1052   b ) extending from the brim member  1050  to the coaptation member  1004 . Referring to  FIG.  10 B , the first arm member  1052   a  extends between and couples a first side portion  1011  of the coaptation member  1004  to a first side portion  1051  of the brim member  1050 , and the second arm member  1052   b  extends between and couples a second side portion  1013  of the coaptation member  1004  to a second side portion  1053  of the brim member  1050 . In some aspects of the present technology, connecting the atrial-fixation member  1002  to the first and second side portion  1011 ,  1013  of the coaptation member  1004  (e.g., rather than an anterior portion  1012  of the coaptation member  1004 ) can increase the stability of the coaptation member  1004  when the implantable device  1000  is implanted at a native valve, thereby improving coaptation been coaptation member  1004  and one or more native leaflets of the native valve. 
     The brim member  1050  can have a generally curved shape in a circumferential direction about the flow axis VA selected to engage the tissue above a native valve (e.g., a native mitral valve) when the implantable device  1000  is implanted at the native valve. Moreover, in the illustrated embodiment the brim member  1050  extends only partially about the flow axis VA such that when the implantable device  1000  is implanted at the native valve, the brim member  1050  only engages a portion (e.g., an anterior portion) of the circumference of the native tissue above the valve (e.g., the tissue of the left atrium). For example, the brim member  1050  can have a length selected to extend between about 40°-100°, between about 45°-90°, and/or between about 50°-70° about the flow axis VA. In contrast, the atrial-fixation members  102 ,  202  shown in  FIGS.  1 A- 9    extend entirely circumferentially (e.g., 360°) about the flow axis VA. In some aspects of the present technology, omitting a posterior portion of the atrial-fixation member  1002  can improve visualization of the implantable device  100  (e.g., the clip  1009 ) during delivery and implantation of the implantable device  1000 . In some aspects of the present technology, the brim member  1050  provides fixation above the native valve (e.g., in the left atrium above the mitral valve) while the arm members  1052  help resist excess deflection of the coaptation member  1004 . 
       FIGS.  11 A and  11 B  are a side view and a top view of the atrial-fixation member  1002  configured in accordance with embodiments of the present technology. Referring to  FIGS.  11 A and  11 B , the atrial-fixation member  1002  can be formed of a mesh, such as a braid or laser-cut stent-like structure, including a plurality of interconnected wires or struts  1006  which together define a plurality of openings or cells  1008  (e.g., diamond-shaped openings) arranged in one or more rows (e.g., two rows). The struts  1006  can be configured to self-expand from a collapsed delivery state (not shown) to an expanded deployed state shown in  FIGS.  11 A and  11 B . In some embodiments, the arm members  1152  are separate (e.g., formed from nitinol wire) from the brim member  1150  and attached thereto via suturing, welding, adhesives, fasteners, and/or the like. In other embodiments, the arm members  1152  are integrally formed with the brim member  1150 . For example, the atrial-fixation member  1002  can be formed as a single laser cut structure. 
     In the illustrated embodiment, the arm members  1152  are identical or generally identical and each include a brim attachment portion  1154  and a coaptation attachment portion  1155 . In the illustrated embodiment, the brim attachment portions  1154  and the coaptation attachment portions  1155  are each bifurcated or forked. The coaptation attachment portions  1155  are configured (e.g., shaped, sized, positioned) to be secured to the coaptation member  1004  ( FIGS.  10 A and  10 B ). For example, the coaptation attachment portions  1155  can be secured to the coaptation member  1004  (e.g., a stent, strut, and/or metal structure thereof) via suturing, welding, adhesives, fasteners, and/or the like. For example, with additional reference to  FIG.  10 B , the coaptation attachment portion  1155  ( FIGS.  11 A and  11 B ) of the first arm member  1052   a  is secured at and/or proximate to the first side portion  1011  of the coaptation member  1004 , and the coaptation attachment portion  1155  ( FIGS.  11 A and  11 B ) of the second arm member  1052   b  is secured at and/or proximate to the second side portion  1013  of the coaptation member  1011 . Likewise, the brim attachment portions  1154  can be secured to the brim member  1150  (e.g., the struts  1006 ) via suturing, welding, adhesives, fasteners, and/or the like, or integrally formed with the brim member  1150 . In some embodiments, the brim attachment portions  1154  are arched or curved. 
     The arm members  1152  can each further include an arched portion  1156  extending between the brim attachment portion  1154  and the coaptation attachment portion  1155 . In the illustrated embodiment, the arched portions  1156  each include (i) a generally straight anterior segment  1157  extending from the brim attachment portion  1154 , (ii) an arched middle segment  1158  extending from the anterior segment  1157 , and (iii) a generally straight posterior segment  1159  extending from the middle segment  1158  to the coaptation attachment portion  1155 . In some embodiments, the middle segments can define an angle A ( FIG.  11 A ) of between about 80°-120°, between about 50°-80°, and/or between about 60°-70°. Referring to  FIGS.  10 A- 11 B  together, the arm members  1052  extend in an anterior direction away from the coaptation member  1004  to the brim member  1050  while, more specifically, (i) the posterior segments  1159  extend in the superior (e.g., upstream) direction away from the coaptation member  1004 , (ii) the middle segments  1158  curvingly extend from the superior direction to the inferior (e.g., downstream) direction, and (iii) the anterior segments  1157  extend in the inferior direction to the brim member  1050 . In the illustrated embodiment, the posterior segments  1159  are longer than the anterior segments  1157  such that the brim member  1050  is positioned superior to (e.g., upstream of) the coaptation member  1004 . 
     Referring to  FIGS.  10 A and  10 B , the implantable device  1000  can include one or more portions of fabric attached to the atrial-fixation member  1002  to facilitate long term tissue ingrowth into the structure of the atrial-fixation member  1002 . For example, in the illustrated embodiment the implantable device  1000  includes a fabric member  1025  attached along a portion of the brim member  1050 . The fabric member  1025  can comprise polyethylene terephthalate (PET) and/or another suitable material that facilitates long term tissue ingrowth, and can be secured to the brim member  1050  via sutures and/or other suitable fasteners. In some embodiments, the atrial-fixation member  1002  can include fixation features in the form of cleats. For example, the brim member  1050  can include upward facing anterior cleats  1015  (e.g., nine upward facing anterior cleats) configured to inhibit or even prevent migration of the implantable device  1000  into the left atrium. 
     In the illustrated embodiment, the coaptation member  1004  extends away from the arm members  1052  along the flow axis VA and at least a portion of the coaptation member  1004  extends radially inward from the arm members  1052  toward the flow axis VA to approximate a closed position of a native leaflet. The coaptation member  1004  can be substantially stationary (e.g., little to no movement) during cardiac cycles such that the position of the coaptation member  1004  relative to the atrial-fixation member  1002  is at least substantially fixed in the deployed state. Thus, unlike native leaflets that move back and forth to open and close the native valve, the coaptation member  1004  remains stationary during diastole and systole. 
     The coaptation member  1004  can have an anterior portion  1012  with a smooth, atraumatic surface for coapting with at least a portion of one or more native leaflets and a posterior portion  1014  configured to displace and, optionally, engage at least a portion of another native leaflet. The coaptation member  1004  can be made from a plurality of struts that form a basket-like or frame-like structure (e.g., a mesh structure, a laser cut stent frame) with an at least partially hollow interior and a covering (e.g., a fabric) extending over at least a portion of the struts to provide a smooth suitable surface for coaptation at the anterior portion  1012 . The covering may also extend over the struts along the posterior portion  1014  and between the anterior and posterior portions  1012 ,  1014  in a manner that forms lateral sidewalls. The coaptation member  1004  or portions thereof can be integral with the arm members  1052  of the atrial-fixation member  1002  such that, for example, the coaptation member  1004  is manufactured from the same frame including the arm members  1052  and/or the brim member  1050 . In other embodiments, the coaptation member  1004  can be a separate structure that is connected to the arm members  1052  during manufacturing. In some embodiments, the coaptation member  1004  can include a biocompatible foam which is attached to the structure of the coaptation member  1004  and/or to the arm members  1052 . Referring to  FIG.  10 B , the covering can comprise a slit  1039  at a superior (e.g., top) portion of the coaptation member  1004  to allow for one or more components (e.g., a baffle screw, core plug, clip tendon) of an associated delivery system to attach to the coaptation member  1004 . The slit  1039  can be configured to close after the coaptation member  1004  is detached from the associated delivery system. 
     In the illustrated embodiment, the coaptation member  1004  includes a brim portion  1060  (also referred to as a “secondary brim portion,” a “posterior brim,” or a “posterior extension”) that may be separate from and coupled to, or integral with, the coaptation member  1004 . The brim portion  1060  extends away from a portion (e.g., a superior-posterior portion) of the coaptation member  1004  in a superior-posterior direction. The brim portion  1060  can be flexible. For example, the brim portion  1060  can comprise a nitinol wire form covered with PET fabric to provide a platform for long term tissue incorporation into the brim portion  1060 . When the implantable device  1000  is implanted at a native valve, the brim portion  1060  can extend above the native valve annulus into the atrium (e.g., the left atrium) above the valve and can contact a portion (e.g., a posterior portion) of the native tissue above the valve (e.g., the tissue of the left atrium). In some aspects of the present technology, the brim portion  1060  is relatively small compared to, for example, the posterior portion of the atrial-fixation members  102 ,  202  shown in  FIGS.  1 A- 9   . This can help minimize undesirable interaction of the implantable device  1000  with the left atrium that may otherwise move or shift the implantable device  1000  relative to the native valve. 
     Referring to  FIG.  10 A , the clip  1009  depends from the posterior portion  1014  of the coaptation member  1004  and can be opened to extend behind the native leaflet the coaptation member  1004  displaces. The clip  1009  may grasp the native leaflet and/or engage sub-annular cardiac tissue for sub-annular stabilization of the implantable device  1000 . In some embodiments, for example, the clip  1009  reaches under the central portion (i.e., P 2 ) of the posterior leaflet up to the sub-annular space. A tendon (made of suture or nitinol wire) can actuate the clip  1009  by way of a lever attached to the clip  1009 . The lever may be a nitinol wire or laser cut nitinol or Co-Cr sheet. 
       FIG.  12    is a side cross-sectional view of the implantable device  1000  of  FIGS.  10 A- 11 B  implanted at a mitral valve in accordance with embodiments of the present technology. In the illustrated embodiment, when the implantable device  1000  is deployed across the mitral valve annulus, the coaptation member  1004  may extend in front of a portion (e.g., a central portion) of a posterior leaflet PL (e.g., the P 2  scallop of the posterior leaflet PL) to position the coaptation member  1004  in a location that allows it to coapt with an anterior leaflet AL during systole (the anterior leaflet is shown during systole in broken lines and in diastole in solid lines in  FIG.  12   ). The clip  1009  is configured to extend behind and grasp portions of one or more native leaflets to affix the one or more leaflets to the coaptation member  1004 . The brim member  1050  contacts an anterior portion of the left atrium LA, and the brim portion  1060  of the coaptation member  1004  extends above the posterior leaflet PL into the left atrium LA. The arm members  1052  extend in an arch into the left atrium LA and to the brim member  1050  to brace and fix the coaptation member  1004  in position. 
       FIG.  13    is a top view of an atrial-fixation member  1302  configured in accordance with additional embodiments of the present technology. The atrial-fixation member  1002  can include some features that are at least generally similar in structure and function, or identical in structure and function, to the corresponding features of the atrial-fixation member  1002  described in detail above with reference to  FIGS.  10 A- 11 B , and can operate in a generally similar or identical manner to the atrial-fixation member  1002  shown in  FIGS.  10 A- 11 B . For example, the atrial-fixation member  1302  can be incorporated into the implantable device  1000  instead of the atrial-fixation member  1002 . 
     In the illustrated embodiment, the atrial-fixation member  1302  comprises a brim member  1350  and arm members  1352  (including an individually identified first arm member  1352   a  and a second arm member  1352   b ) extending from the brim member  1350  and configured to be coupled to a coaptation member (e.g., the coaptation member  1004  of  FIGS.  10 A and  10 B ). The first arm member  1352   a  extends between and couples a first side portion of the coaptation member to a first side portion of the brim member  1350 , and the second arm member  1352   b  extends between and couples a second side portion of the coaptation member to a second side portion of the brim member  1350 . The brim member  1350  can have a generally curved shape in a circumferential direction about a flow axis of the implantable device selected to engage the tissue above a native valve (e.g., a native mitral valve) when the implantable device is implanted at the native valve. Moreover, in the illustrated embodiment the brim member  1350  extends only partially about the flow axis such that when the implantable device is implanted at the native valve, the brim member  1350  only engages a portion (e.g., an anterior portion) of the circumference of the native tissue above the valve (e.g., the tissue of the left atrium). The atrial-fixation member  1302  can be formed of a mesh, such as a braid or laser-cut stent-like structure, including a plurality of interconnected wires or struts  1306  which together define a plurality of openings or cells  1308  (e.g., diamond-shaped openings) arranged in one or more rows (e.g., two rows). In the illustrated embodiment, the arm members  1352  each comprise a pair of generally parallel first (e.g., outer) struts  1361  connected by second (e.g., inner) struts  1362 . The second struts  1362  can have a diamond like shape. 
       FIGS.  14 A and  14 B  are a side view (e.g., an anterior-posterior side view) and a top view (e.g., an en face view) of an implantable device  1400  that can be implanted within a heart of a subject (e.g., a human patient) in accordance with embodiments of the present technology. The implantable device  1400  can include some features that are at least generally similar in structure and function, or identical in structure and function, to the corresponding features of the implantable device  100 , the implantable device  200 , and/or the implantable device  1000  described in detail above with reference to  FIGS.  1 A- 13   , and can operate in a generally similar or identical manner to the implantable devices shown in  FIGS.  1 A- 13   . 
     For example, referring to  FIGS.  14 A and  14 B , in the illustrated embodiment the implantable device  1400  is a valve repair device having an atrial-fixation member  1402  (also referred to as an “anterior brim,” an “anterior-only brim,” an “anterior anchoring member,” or a “suprannular anchoring member”) and a coaptation member  1404  extending from the atrial-fixation member  1402  in a downstream direction. The atrial-fixation member  1402  is configured to anchor the implantable device  1400  to cardiac tissue proximate to a native mitral valve annulus and position the coaptation member  1404  at a desired location with respect to the native valve anatomy of the heart. The implantable device  1400  is designed to eliminate regurgitation by restoring physiologic coaptation in a diseased mitral valve. The coaptation member  1404  can be covered in a biocompatible material (e.g., polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE)) and shaped (e.g., contoured) to fill a regurgitant orifice of the mitral valve from the posterior side and provide a new coaptation surface for the native leaflets of the mitral valve. The atrial-fixation member  1402  can be flexible and can provide additional fixation and supra-annular stabilization. In the illustrated embodiment, the implantable device  1400  further includes a posterior clip  1409  (obscured in  FIG.  14 B ) that can orient the implantable device  1400  and provide sub-annular fixation. 
     The implantable device  1400  is configured relative to a flow axis VA ( FIG.  14 A ) in the direction of blood flow from the atrium to the ventricle and a transverse axis HA ( FIG.  14 B ) at an angle (e.g., orthogonal) to the flow axis VA. As shown in  FIG.  14 A , the implantable device  1400  has a posterior side portion P (e.g., a first side portion), an anterior side portion A (e.g., a second side portion), a superior end portion S (e.g., a first end portion), and an inferior end portion I (e.g., a second end portion). 
       FIGS.  15 A and  15 B  are a side view and a perspective top view of the atrial-fixation member  1402  configured in accordance with embodiments of the present technology. Referring to  FIGS.  14 A- 15 B , the atrial-fixation member  1402  can be formed of a mesh, such as a braid or laser-cut stent-like structure, including a plurality of interconnected wires or struts  1406  which together define a plurality of openings or cells  1408  (e.g., diamond-shaped openings) arranged in one or more rows (e.g., two rows). The struts  1406  can be configured to self-expand from a collapsed delivery state (not shown) to an expanded deployed state shown in  FIGS.  14 A and  14 B . In the illustrated embodiment, the atrial-fixation member  1402  comprises (i) an anterior brim portion  1450  at and/or proximate the anterior side portion A of the implantable device  1400 , (ii) a pair of medial extension portions  1451  extending in a posterior direction from the brim portion  1450 , and (iii) a pair of posterior connection portions  1452  (including an individually identified first posterior connection portion  1452   a  and a second posterior connection portion  1452   b ) extending in a posterior-inferior direction from the extension portions  1451  to the coaptation member  1404 . More specifically, as shown in  FIG.  14 B , the first posterior connection portion  1452   a  is secured at and/or proximate to a first side portion  1451  of the coaptation member  1404 , and the second posterior connection portion  1452   b  is secured at and/or proximate to a first side portion  1413  of the coaptation member  1404 . In some aspects of the present technology, connecting the atrial-fixation member  1402  to the first and second side portion  1411 ,  1413  of the coaptation member  1404  (e.g., rather than an anterior portion  1412  of the coaptation member  1404 ) can increase the stability of the coaptation member  1404  when the implantable device  1400  is implanted at a native valve, thereby improving coaptation been coaptation member  1404  and one or more native leaflets of the native valve. 
     The brim portion  1450  can have a generally curved shape in a circumferential direction about the flow axis VA selected to engage the tissue above a native valve (e.g., a native mitral valve) when the implantable device  1400  is implanted at the native valve. Moreover, in the illustrated embodiment the brim portion  1450  extends only partially about the flow axis VA such that when the implantable device  1400  is implanted at the native valve, the brim portion  1450  only engages a portion (e.g., an anterior portion) of the circumference of the native tissue above the valve (e.g., the tissue of the left atrium). For example, the brim portion  1450  can have a length selected to extend only between about 40°-140°, between about 45°-90°, and/or between about 50°-70° about the flow axis VA. In contrast, the atrial-fixation members  102 ,  202  shown in  FIGS.  1 A- 9    extend entirely circumferentially (e.g., 360°) about the flow axis VA. In some aspects of the present technology, omitting a posterior portion of the atrial-fixation member  1402  can improve visualization of the implantable device  1400  (e.g., the clip  1409 ) during delivery and implantation of the implantable device  1400 . In some aspects of the present technology, the atrial-fixation member  1402  provides fixation above the native valve (e.g., in the left atrium above the mitral valve) and also helps resist excess deflection of the coaptation member  1404 . 
     As best seen in  FIGS.  14 B and  15 B , the atrial-fixation member  1402  can have a circumferential U-like shape about the flow axis VA ( FIG.  14 A ). In some embodiments, the extension portions  1451  taper inward toward the flow axis VA in the anterior direction from the brim portion  1450  to the coaptation member  1404 . Referring to  FIGS.  15 A and  15 B , one or more of the struts  1406  (identified as “attachment struts  1406   a ”) near a posterior end of each of the connection portions  1452  can define a region for attachment to the coaptation member  1404  ( FIGS.  14 A and  14 B ). The attachment struts  1406   a  are configured (e.g., shaped, sized, positioned) to be secured to the coaptation member  1404  (e.g., a stent, strut, and/or metal structure thereof) via suturing, welding, adhesives, fasteners, and/or the like. Referring to  FIGS.  14 A and  14 B , the connection portions  1452  act to position the brim portion  1450  and the extension portions  1451  generally superior to (e.g., upstream of) the coaptation member  1404  (e.g., above the anterior portion  1412  and coaptation surface of the coaptation member  1404 ). Referring to  FIG.  14 A , in some embodiments the atrial-fixation member  1402  can curve or taper downward (e.g., in the inferior direction) in the anterior direction. For example, the atrial-fixation member  1402  can have a curved or “rainbow” shape in which (i) an uppermost portion of the connection portions  1452  is positioned above an uppermost portion of the extension portions  1451 , and (ii) an uppermost portion of the extension portions  1451  is positioned above an uppermost portion of the brim portion  1450 . That is, a superior portion of the atrial-fixation member  1402  can taper downward relative to the flow axis VA from the extension portions  1451  toward the brim portion  1450 . In some aspects of the present technology, such a curved shape of the atrial-fixation member  1402  can help inhibit interference of the atrial-fixation member  1402  with the medial and lateral aspects of native leaflets when the implantable device is  1400  is positioned at a native valve.  FIGS.  15 A and  15 B  illustrate the atrial-fixation member  1402  without such a curved or “rainbow” shape and instead including a superior portion having a generally linear or flat shape relative to the transverse axis HA ( FIG.  10 B ). 
     In some embodiments, the implantable device  1400  can include one or more portions of fabric attached to the atrial-fixation member  1402  to facilitate long term tissue ingrowth into the structure of the atrial-fixation member  1402 . For example, in the illustrated embodiment the implantable device  1400  includes a fabric member  1425  attached along a portion of the brim portion  1450 . The fabric member  1425  can comprise polyethylene terephthalate (PET) and/or another suitable material that facilitates long term tissue ingrowth, and can be secured to the brim portion  1450  via sutures and/or other suitable fasteners (e.g., adhesives). In some embodiments, the atrial-fixation member  1402  can include fixation features in the form of cleats. For example, the brim portion  1450  can include upward facing anterior cleats  1415  (e.g., nine upward facing anterior cleats) and/or downward facing posterior cleats  1463  (e.g., two downward facing posterior cleats) to inhibit or even prevent migration of the implantable device  1400  into the left atrium. In some embodiments, the downward facing posterior cleats  1463  originate from (e.g., extend from) the coaptation member  204 . As best seen in  FIGS.  14 B and  15 B , the atrial-fixation member  1402  can include connectors  1405  that are configured (e.g., sized, shaped, and/or positioned) to engage with one or more mating features on an associated delivery system. The connectors  1405  can extend from the struts  1406  such that the connectors  1405  are positioned at or near the superior end portion S ( FIG.  14 A ) of the implantable device  1400 . In the illustrated embodiment, the implantable device  1400  includes two of the connectors  1405 . In some aspects of the present technology, the connectors  1405  can help maintain the implantable device  1400  in a rotatably stable position as the clip  1409  is opened and closed. 
     In the illustrated embodiment, the coaptation member  1404  extends away from the connection portions  1452  along the flow axis VA and at least a portion of the coaptation member  1404  extends radially inward from the connection portions  1452  toward the flow axis VA to approximate a closed position of a native leaflet. The coaptation member  1404  can be substantially stationary (e.g., little to no movement) during cardiac cycles such that the position of the coaptation member  1404  relative to the atrial-fixation member  1402  is at least substantially fixed in the deployed state. Thus, unlike native leaflets that move back and forth to open and close the native valve, the coaptation member  1404  remains stationary during diastole and systole. 
     The coaptation member  1404  or portions thereof can be integral with the connection portions  1452  of the atrial-fixation member  1402  such that, for example, the coaptation member  1404  is manufactured from the same frame including the atrial-fixation member  1402 . In other embodiments, the coaptation member  1404  can be a separate structure that is connected to connection portions  1452  during manufacturing. In some embodiments, the coaptation member  1404  can include a biocompatible foam which is attached to the structure of the coaptation member  1404  and/or to the atrial-fixation member  1402 . 
     The coaptation member  1404  can have an anterior portion  1412  with a smooth, atraumatic surface for coapting with at least a portion of one or more native leaflets and a posterior portion  1414  configured to displace and, optionally, engage at least a portion of another native leaflet. In the illustrated embodiment, the coaptation member  1404  includes a brim member  1460  (also referred to as a “posterior brim” or a “posterior extension”) that may be separate from and coupled to, or integral with the coaptation member  1404 . The brim member  1460  extends away from a portion (e.g., a superior-posterior portion) of the coaptation member  1404  in a superior-posterior direction. The brim member  1460  can be flexible. For example, the brim member  1460  can comprise a nitinol wire form covered with PET fabric to provide a platform for long term tissue incorporation into the brim member  1460 . When the implantable device  1400  is implanted at a native valve, the brim member  1460  can extend above the native valve annulus into the atrium (e.g., the left atrium) above the valve and can contact a portion (e.g., a posterior portion) of the native tissue above the valve (e.g., the tissue of the left atrium). In some aspects of the present technology, the brim member  1460  is relatively small compared to, for example, the posterior portion of the atrial-fixation members  142 ,  202  shown in  FIGS.  1 A- 9   . This can help minimize undesirable interaction of the implantable device  1400  with the left atrium that may otherwise move or shift the implantable device relative to the native valve. 
     The coaptation member  1404  can be made from a plurality of struts that form a basket-like or frame-like structure (e.g., a mesh structure, a laser cut stent frame) with an at least partially hollow interior and a covering  1417  (e.g., a fabric) extending over at least a portion of the struts to provide a smooth suitable surface for coaptation at the anterior portion  1412 . More specifically,  FIGS.  16 A- 16 C  are side views (e.g., an anterior side view, a perspective posterior side view, and an anterior-posterior side view, respectively) of the coaptation member  104  with the covering  1417  removed in accordance with embodiments of the present technology. The coaptation member  1404  can be formed of a mesh, such as a braid or laser-cut stent-like structure, including a plurality of interconnected wires or struts  1630  which together define a plurality of openings or cells  1632  (partially obscured in  FIG.  16 C ). The struts  1630  further define a hollow interior  1631  and the brim member  1460 . As best seen in  FIG.  16 C , the struts  1630  at the brim member  1460  can each include (i) a generally straight segment  1661  extending from the struts  1630  surrounding the hollow interior  1631  and (ii) an arched or curved superior segment  1662  extending from the generally straight segment  1661 . The straight segments  1661  can extend in a posterior-superior direction, and the superior segments  1662  can extend in the superior direction while also curving from the posterior direction to the anterior direction. In some embodiments, the posterior cleats  1463  can be integral with and/or formed by the struts  1630  and can extend in the posterior-inferior (e.g., downward) direction from corresponding ones of the superior segments  1662 . 
     With additional reference to  FIGS.  14 A and  14 B , the covering  1417  of the coaptation member  1404  and the brim member  1460  can extend over the struts  1630  along the posterior portion  1414  and between the anterior and posterior portions  1412 ,  1414  in a manner that forms lateral sidewalls. Referring to  FIG.  14 B , the covering  1417  can comprise a slit  1439  at a superior (e.g., top) portion of the coaptation member  1404  to allow for one or more components (e.g., a baffle screw, core plug, clip tendon) of an associated delivery system to attach to the coaptation member  1404 . The slit  1439  can be configured to close after the coaptation member  1404  is detached from the associated delivery system. 
     Referring to  FIG.  14 A , the clip  1409  depends from the posterior portion  1414  of the coaptation member  1404  and can be opened to extend behind the native leaflet the coaptation member  1404  displaces. The clip  1409  may grasp the native leaflet and/or engage sub-annular cardiac tissue for sub-annular stabilization of the implantable device  1400 . In some embodiments, for example, the clip  1409  reaches under the central portion (i.e., P 2 ) of the posterior leaflet up to the sub-annular space. A tendon (made of suture or nitinol wire) can actuate the clip  1409  by way of a lever attached to the clip  1409 . The lever may be a nitinol wire or laser cut nitinol or Co-Cr sheet. 
       FIG.  17    is a side cross-sectional view of the implantable device  1400  of  FIGS.  14 A- 16 C  implanted at a mitral valve MV in accordance with embodiments of the present technology. In the illustrated embodiment, when the implantable device  1400  is deployed across the mitral valve MV annulus, the coaptation member  1404  may extend in front of a portion (e.g., a central portion) of a posterior leaflet PL (e.g., the P 2  scallop of the posterior leaflet PL) to position the coaptation member  1404  in a location that allows it to coapt with an anterior leaflet AL during systole (the anterior leaflet is shown during systole in broken lines and in diastole in solid lines in  FIG.  17   ). The clip  1409  is configured to extend behind and grasp portions of one or more native leaflets to affix the one or more leaflets to the coaptation member  1404 . The brim portion  1450  of the atrial-fixation member  1402  contacts an anterior portion of the left atrium LA, and the brim member  1460  of the coaptation member  1404  extends above the posterior leaflet PL into the left atrium. The atrial-fixation member  1402  extends in an anterior-superior direction from the coaptation member  1404  into the left atrium LA to brace and fix the coaptation member  1404  in position. 
       FIGS.  18 - 22 B  illustrate additional embodiments of clip assemblies (also referred to as “clips,” “clip mechanisms,” and the like) for use with the implantable devices of the present technology. Accordingly, any of the clip assemblies and/or components thereof described in detail with reference to  FIGS.  18 - 22 B  can be incorporated into any of the implantable devices described in detail with reference to  FIGS.  1 A- 17   . 
       FIG.  18    is a side view of a coaptation member  1804  and an associated clip assembly  1809  configured in accordance with embodiments of the present technology. The coaptation member  1804  is shown as partially transparent in  FIG.  18    for clarity. The coaptation member  1804  is configured to be secured to an atrial-fixation member (not shown) and can have an anterior portion  1812  with a smooth, atraumatic surface for coapting with at least a portion of one or more native leaflets and a posterior portion  1814  configured to displace and, optionally, engage at least a portion of another native leaflet. In the illustrated embodiment, the clip assembly  1809  comprises (i) a clip member  1870  having a root portion  1871  and an arm portion  1872  extending from the root portion  1871 , (ii) a back member  1873  positioned within the coaptation member  1804 , (iii) a threaded member  1874 , and (iv) an actuation member  1875 . Some or all of the components of the clip assembly  1809  can be made from cobalt-chromium (Co-Cr), nitinol, stainless steel (e.g., SS316L stainless steel), and/or the like, and can be machined via, for example, wire electrical discharge machining (WEDM). 
     The back member  1873  can be secured to an internal structure (e.g., a stent structure) of the coaptation member  1804  such that it is fixedly attached to the coaptation member  1804 . The clip assembly  1809  is shown in a closed configuration (e.g., a closed position) in  FIG.  18    in which the arm portion  1872  of the clip member  1870  abuts and/or is proximate to the coaptation member  1804  (e.g., the posterior portion  1814  of the coaptation member  1804 ). In some embodiments, in the closed configuration, the arm portion  1872  can be at least partially positioned in a recess in the covering of the coaptation member  1804 . 
     In the illustrated embodiment, the back member  1873  has a first (e.g., upper) horizontal portion  1876   a  and a second (e.g., lower) horizontal portion  1876   b  connected to respective end portions of an elongate vertical portion  1877 . The first horizontal portion  1876   a  defines a first aperture  1878   a  therethrough, and the second horizontal portion  1876   b  defines a second aperture  1878   b  therethrough. In some embodiments, the second aperture  1878   b  can be stepped. In the illustrated embodiment, the threaded member  1874  can have a first (e.g., upper) head  1879   a  and a second (e.g., lower) head  1879   b  connected by a partially threaded rod  1880 . The rod  1880  can extend through the first aperture  1878   a  and partially through the second aperture  1878   b  and can rotate therein. In some embodiments, the second head  1879   b  is rotatably retained within the stepped second aperture  1878   b  such that the second head  1879   b  is prevented from moving upward through the second aperture  1878   b . Similar, the first head  1879   a  is positioned above the first horizontal portion  1876   a  and sized such that the first head  1879   a  cannot pass downward through the first aperture  1878   a . The first head  1879   a  can have a drive recess  1881  (e.g., a slotted recess, a hex recess, a square recess, and/or the like) for releasably receiving a component of an associated delivery system. The component of the associated delivery system can be actuated (e.g., rotated) to rotate the threaded member  1874 . 
     In the illustrated embodiment, the root portion  1871  is pivotably coupled to the vertical portion  1877  of the back member  1873  via, for example, a pin  1882 . The root portion  1871  further includes a slot  1883  having a first end portion  1884   a  and a second end portion  1884   b . The slot  1883  can extend generally linearly and, in the closed configuration shown in  FIG.  18   , is angled off vertical (e.g., angled relative to the threaded member  1874  and/or the vertical portion  1877  of the back member  1873 ). The actuation member  1875  can be a threaded nut secured to the threaded portion of the rod  1880 . In the illustrated embodiment, the actuation member  1875  includes a projection  1885  extending into the slot  1883  of the root portion  1871 . 
     In the closed configuration shown in  FIG.  18   , the projection  1885  is positioned at or proximate the first end portion  1884   a  of the slot  1883 . To actuate the clip assembly  1809  to open the arm portion  1872 —e.g., pivot the arm portion  1872  away from the coaptation member  1804  in the direction of arrow  0 —the threaded member  1874  can be rotated in a first direction via the component of the associated delivery system which engages the drive recess  1881 . Rotation of the threaded member  1874  in the first direction drives the actuation member  1875  upward toward the first horizontal portion  1876   a  along the threads of the rod  1880 . As the actuation member  1875  moves upward, the projection  1885  moves along the slot  1883  from the first end portion  1884   a  toward the second end portion  1884   b  and drives the root portion  1871  to pivot about the pin  1882  in a clockwise direction and thus the arm portion  1872  to pivot open in the direction of the arrow  0 . The clip assembly  1809  can reach a fully open position when the projection  1885  reaches the second end portion  1884   b  of the slot  1883 . In some embodiments, the arm portion  1872  can pivot open by about 90° relative to the back member  1873  and the posterior portion  1814  of the coaptation member  1804 . The second end portion  1884   b  can function as a hard stop that prevents further opening of the clip member  1870 . 
     To actuate the clip assembly  1809  to close the arm portion  1872 —e.g., pivot the arm portion  1872  toward the coaptation member  1804  in the direction of arrow C—the threaded member  1874  can be rotated in a second direction opposite the first direction via the component of the associated delivery system which engages the drive recess  1881 . Rotation of the threaded member  1874  in the second direction drives the actuation member  1875  downward toward the second horizontal portion  1876   b  along the threads of the rod  1880 . As the actuation member  1875  moves downward, the projection  1885  moves along the slot  1883  from the second end portion  1884   b  toward the first end portion  1884   a  and drives the root portion  1871  to pivot about the pin  1882  in a counterclockwise direction and thus the arm portion  1872  to pivot closed in the direction of the arrow C. 
       FIG.  19 A  is a side view of a clip assembly  1909  configured in accordance with additional embodiments of the present technology. The clip assembly  1909  can include some features that are at least generally similar in structure and function, or identical in structure and function, to the corresponding features of the clip assembly  1809  described in detail above with reference to  FIG.  18   , and can operate in a generally similar or identical manner to the clip assembly shown in  FIG.  18   . 
     For example, in the illustrated embodiment the clip assembly  1909  comprises (i) a clip member  1970  having a root portion  1971  and an arm portion  1972  extending from the root portion  1971 , (ii) a back member  1973  configured to be positioned within a coaptation member, (iii) a threaded member  1974 , and (iv) an actuation member  1975 . The back member  1973  has a first (e.g., upper) horizontal portion  1976   a  and a second (e.g., lower) horizontal portion  1976   b  connected to respective end portions of an elongate vertical portion  1977  and having first and second apertures  1978   a - b  ( FIG.  19 B ), respectively, extending vertically therethrough. In the illustrated embodiment, the threaded member  1974  has (i) a first (e.g., upper) head  1979   a  positioned above the first horizontal portion  1976   a , (ii) a second (e.g., lower) head  1979   b  rotatably retained in the second aperture  1978   b  ( FIG.  19 B ) in the second horizontal portion  1976   b , and (iii) a partially threaded rod  1980  extending between the upper and lower heads  1979   a - b  and at least partially through the first and second apertures  1978   a - b  ( FIG.  19 B ) in the first and second horizontal portions  1976   a - b , respectively. The first head  1979   a  can have a driving recess (e.g., a slotted recess, a hex recess, a square recess, and/or the like) for releasably receiving a component of an associated delivery system. The root portion  1971  is pivotably coupled to the vertical portion  1977  of the back member  1973  via, for example, a pin  1982 . The root portion  1971  further includes a slot  1983  having a first end portion  1984   a  and a second end portion  1984   b . In some embodiments, the slot  1983  can have a V-shape that is, in the closed configuration shown in  FIG.  19 A , angled off vertical (e.g., angled downward relative to the threaded member  1974  and/or the vertical portion  1977  of the back member  1973 ). The actuation member  1975  can be a threaded nut secured to the threaded portion of the rod  1980  and having a projection  1985  extending into the slot  1983  of the root portion  1971 . 
     In the illustrated embodiment, the clip assembly  1909  further includes an attachment member  1986  (also referred to as a “spider member”) coupled to the vertical portion  1977  of the back member  1973  opposite the threaded member  1974 . For example, the attachment member  1986  can be secured via rivets  1987  to the back member  1973 .  FIG.  19 B  is a perspective side view of the clip assembly  1909  showing only the back member  1973  and the attachment member  1986  coupled thereto in accordance with embodiments of the present technology. Referring to  FIGS.  19 A and  19 B , the attachment member  1986  can include (i) a middle body portion  1988 , (ii) first (e.g., upper) arm or finger portions  1989   a  (e.g., three finger portions  1989   a ) extending upward from the body portion  1988 , and (iii) second (e.g., lower) arm or finger portions  1989   b  (e.g., three finger portions  1989   b ) extending downward from the body portion  1988 . The first and second finger portions  1989   a - b  can splay outward from the body portion  1988 . The body portion  1988  and/or one or more of the second finger portions  1989   b  can be secured to the back member  1973  via the rivets  1987 . 
     The attachment member  1986  is configured to be secured to a coaptation member of an implantable device such that the clip assembly  1909  is fixedly attached to the coaptation member. In some embodiments, the attachment member  1986  can be secured to the coaptation member via suturing. For example, one or more sutures can be threaded through eyelets or apertures  1990  ( FIG.  19 B ) formed in distal end portions of one or more of the first and second finger portions  1989   a - b . In some aspects of the present technology, securing the attachment member  1986  to the coaptation member via suturing can reduce the likelihood of corrosion as compared to, for example, fastening techniques that require metal interconnections (e.g., riveting). 
     In the illustrated embodiment, the attachment member  1986  has a planform shape (e.g., as shown in the side view of  FIG.  19 A ) that generally tracks or matches the planform shape of the arm portion  1972  of the clip member  1970 . For example, the arm portion  1972  can have a generally flat first (e.g., lower) segment  1991  coupled to the root portion  1971  and a curved second (e.g., upper) segment  1992  extending from the first segment  1991 . The second segment  1992  can curve in the posterior direction away from, for example, the back member  1973 . Similarly, the body portion  1988  and the second finger portions  1989   b  of the attachment member  1986  can be generally flat, and the first finger portions  1989   a  of the attachment member  1986  can be curved. In the closed configuration shown in  FIG.  19 A , the body portion  1988  and the second finger portions  1989   b  of the attachment member  1986  can be positioned adjacent to and generally parallel to the first segment  1991  of the arm portion  1972 , and the first finger portions  1989   a  of the attachment member  1986  can be positioned adjacent to and generally parallel to the second segment  1992  of the arm portion  1972 . Accordingly, in the closed configuration, the arm portion  1972  can be spaced apart from the attachment member  1986  by a gap G having a generally constant dimension (e.g., within about 20% of a set value along the length of the arm portion  1972 ). In some aspects of the present technology, this configuration of the arm portion  1972  and the attachment member  1986  allows the clip assembly  1909  to clamp a leaflet positioned between the attachment member  1986  and the arm portion  1972  along substantially the entire length of the arm portion  1972 . This can improve the fixation of the leaflet within the clip assembly  1909 . 
     Referring to  FIG.  19 A , in the illustrated closed configuration, the projection  1985  is positioned at or proximate the first end portion  1984   a  of the slot  1983 , which is angled off vertical. To actuate the clip assembly  1909  to open the arm portion  1972 —e.g., pivot the arm portion  1972  away from the attachment member  1986  in the direction of arrow  0 —the threaded member  1974  can be rotated in a first direction via the component of the associated delivery system which engages the drive recess in the first head  1979   a . Rotation of the threaded member  1974  in the first direction drives the actuation member  1975  upward toward the first horizontal portion  1976   a  along the threads of the rod  1980 . As the actuation member  1975  moves upward, the projection  1985  moves along the slot  1983  from the first end portion  1984   a  toward the second end portion  1984   b  and drives the root portion  1971  to pivot about the pin  1982  in a clockwise direction and thus the arm portion  1972  to pivot open in the direction of the arrow  0 . The clip assembly  1909  can reach a fully open position when the projection  1985  reaches the second end portion  1984   b  of the slot  1983 . In some embodiments, the arm portion  1972  can pivot open by about 90° relative to the back member  1973  and the attachment member  1986 . The second end portion  1984   b  can function as a hard stop that prevents further opening of the clip member  1970 . 
     To actuate the clip assembly  1909  to close the arm portion  1972 —e.g., pivot the arm portion  1972  toward the attachment member  1986  in the direction of arrow C—the threaded member  1974  can be rotated in a second direction opposite the first direction via the component of the associated delivery system which engages the drive recess in the first head  1979   a . Rotation of the threaded member  1974  in the second direction drives the actuation member  1975  downward toward the second horizontal portion  1976   b  along the threads of the rod  1980 . As the actuation member  1975  moves downward, the projection  1985  moves along the slot  1983  from the second end portion  1984   b  toward the first end portion  1984   a  and drives the root portion  1971  to pivot about the pin  1982  in a counterclockwise direction and thus the arm portion  1972  to pivot closed in the direction of the arrow C. 
     Some or all of the components of the clip assembly  1909  can be made from cobalt-chromium (Co-Cr), nitinol, stainless steel (e.g., SS316L stainless steel), and/or the like, and can be machined via, for example, wire electrical discharge machining (WEDM). In some embodiments, the attachment member  1986  can be formed from nitinol and/or another suitable material and can be electropolished. In some embodiments, the attachment member  1986  and the arm portion  1972  of the clip member  1970  are formed from nitinol, and the rest of the components of the clip assembly  1909  are formed from stainless steel. In some embodiments, the arm portion  1972  can be relatively flexible such as, for example, when the arm portion  1972  is formed of nitinol. In some aspects of the present technology, the flexible arm portion  1972  can be configured to sustain anatomical loads but to flex or deform in response to stronger-than-anatomical loads. This can enable recapture of an implantable device employing the clip assembly  1909 . For example, if the clip assembly  1909  cannot be fully closed after deployment of the implantable device and before recapture of the implantable device, the implantable device can still be retracted into a catheter of an associated delivery system because the arm portion  1972  will flex (e.g., evert) as the implantable device is withdrawn into the catheter rather than catching against the end of the catheter and preventing recapture. 
       FIG.  20    is an enlarged perspective side view (e.g., an enlarged perspective posterior side view) of the coaptation member  1404  of  FIGS.  14 A and  14 B  including the clip assembly  1909  of  FIGS.  19 A and  19 B  in accordance with embodiments of the present technology. The clip assembly  1909  is shown in an open or partially open position in  FIG.  20    in which the clip member  1970  is pivoted away from the posterior portion  1414  of the coaptation member  1404 . Referring to  FIGS.  19 A- 20   , the attachment member  1986  (show in dashed line in  FIG.  20   ) of the clip assembly  1909  is secured to the coaptation member  1404  via suturing  2093  that connects one or more of the first and second finger portions  1989   a - b  (e.g., the apertures  1990 ; obscured in  FIG.  20   ) to one or more of the struts  1630  and the covering  1417  of the coaptation member  1404 . The covering  1417  can cover the attachment member  1986 . The coaptation member  1404  can include one or more cleats  1994  at the posterior portion  1414  in the region behind the clip member  1970  (e.g., between the attachment member  1986  the arm portion  1972 ) and projecting past the covering  1417 . The cleats  1994  can be downward facing and configured to fix to a native leaflet clamped by the clip assembly  1909 . In some aspects of the present technology, the cleats  1994  can improve fixation of the coaptation member  1404  to the native leaflet and inhibit atrial migration of the coaptation member  1404 . 
     Referring to  FIG.  20   , the clip assembly  1909  further includes (i) a first fabric layer  2095  around the arm portion  1972  and at least a portion of the root portion  1971  of the clip member  1970  and (ii) a second fabric layer  2096  around at least a portion of the arm portion  1972  (e.g., the second segment  1992  thereof shown in  FIGS.  19 A and  19 B ). The first and second fabric layers  2095 ,  2096  can comprise a biocompatible material such as PTFE or ePTFE. In some embodiments, the first fabric layer  2095  comprises PTFE and the second fabric layer  2096  comprises ePTFE. In some embodiments, the second fabric layer  2096  is thicker than the first fabric layer  2095 . 
     The first and second fabric layers  2095 ,  2096  can be secured to the clip member  1970  via suturing before the clip assembly  1909  is secured to coaptation member  1404 . More specifically, for example,  FIGS.  21 A- 21 C  are side views (e.g., a posterior side view, a posterior side view, and a perspective anterior side view, respectively) illustrating the sequential attachment of the first fabric layer  2095  to the clip member  1970  in accordance with embodiments of the present technology. Referring to  FIG.  20 A , the first fabric layer  2095  can be wrapped or folded around the arm portion  1972  and a portion of the root portion  1971  of the clip member  1970 , and then a suture  2197  can be inserted through the folded first fabric layer  2095 . Referring to  FIGS.  21 A and  21 B , the suture  2197  can then be repeatedly inserted (e.g., using a needle coupled to the suture  2197 ) through the folded first fabric layer  2095  and wound about the arm portion  1972  and the root portion  1971  to secure the first fabric layer  2095  to the clip member  1970 .  FIG.  20 C  shows the clip assembly  1909  in an open or partially open configuration after the first fabric layer  2095  is secured to the clip member  1970 . 
       FIGS.  22 A and  22 B  are a perspective side view (e.g., a perspective posterior side view) and a side view (e.g., a posterior side view) illustrating the sequential attachment of the second fabric layer  2096  to the clip member  1970  in accordance with embodiments of the present technology. Referring to  FIG.  22 A , the second fabric layer  2096  can be wrapped or folded around at least a portion of the arm portion  1972  (e.g., all or a portion of the second segment  1992  shown in  FIGS.  19 A and  19 B ) of the clip member  1970  and over the first fabric layer  2095  thereon. A suture  2197  can then be inserted through the folded second fabric layer  2096  via a needle  2099 . Referring to Referring to  FIGS.  22 A and  22 B , the suture  2198  can then be repeatedly inserted (e.g., using the needle  2099 ) through the folded second fabric layer  2096  and wound about the arm portion to secure the second fabric layer  2096  to the arm portion  1972 . 
     The following examples are illustrative of several embodiments of the present technology: 
     1. A valve repair device for repairing a cardiac valve including a first native leaflet and a second native leaflet opposite the first native leaflet, the valve repair device comprising:
         a coaptation member comprising (a) an inner portion having a coaptation surface configured to coapt with the first native leaflet during systole and (b) an outer portion configured to displace at least a portion of the second native leaflet; and   an atrial-fixation member comprising a plurality of interconnected struts having a circumferential U-like shape about a flow axis of the cardiac valve, wherein the atrial-fixation member extends upward from the coaptation member relative to the flow axis, wherein the interconnected struts define a brim portion and a pair of connection portions, wherein the connection portions are coupled to the coaptation member, and wherein the brim portion is configured to press against cardiac tissue above the first native leaflet proximate to a native valve annulus of the cardiac valve.       

     2. The valve repair device of example 1 wherein the atrial-fixation member is configured not to press against cardiac tissue above the second native leaflet proximate to the native valve annulus. 
     3. The valve repair device of example 1 or example 2 wherein the brim portion is positioned above the coaptation surface along the flow axis. 
     4. The valve repair device of any one of examples 1-3 wherein the atrial-fixation member has a medial portion between the connection portions and the brim portion, and wherein a superior portion of the atrial-fixation member tapers downward relative to the flow axis from the medial portion to the brim portion. 
     5. The valve repair device of any one of examples 1-4 wherein the brim portion includes a plurality of cleats extending upward relative to the flow axis. 
     6. The valve repair device of any one of examples 1-5 wherein the brim portion includes two or more connectors configured to be coupled to a delivery system for maintaining the coaptation member rotationally stable during implantation of the valve repair device at the cardiac valve. 
     7. The valve repair device of any one of examples 1-6 wherein the coaptation member includes a secondary brim portion configured to press against cardiac tissue above the second native leaflet proximate to the native valve annulus. 
     8. The valve repair device of example 7 wherein the secondary brim portion comprises a plurality of interconnected struts covered with a biocompatible material. 
     9. The valve repair device of example 7 or example 8 wherein the secondary brim portion curves in a direction away from the brim portion of the atrial-fixation member back toward the brim portion of the atrial-fixation member. 
     10. The valve repair device of any one of examples 7-9 wherein the coaptation member comprises a plurality of interconnected struts defining the secondary brim portion and a hollow interior volume within the coaptation member, and wherein the struts are covered with a biocompatible material. 
     11. The valve repair device of any one of examples 7-10, further comprising two or more cleats extending from the secondary brim portion downward relative to the flow axis. 
     12. The valve repair device of any one of examples 1-11 wherein the coaptation member includes (a) a first side portion between the inner portion and the outer portion and (b) a second side portion, opposite the first side portion, between the inner portion and the outer portion, wherein a first one of the connection portions is coupled proximate to the first side portion of the coaptation member, and wherein a second one of the connection portions is coupled proximate to the second side portion of the coaptation member. 
     13. The valve repair device of any one of examples 1-12, further comprising:
         a clip assembly coupled to the coaptation member and configured to secure the second native leaflet, wherein the clip assembly comprises:
           a back member;   a clip member having an arm portion and a root portion, wherein the root portion is pivotably coupled to the back member, and wherein the root portion defines a slot;   a threaded member coupled to the back member and configured to rotate relative to the back member; and   an actuation member coupled to the threaded member, wherein the actuation member includes a projection extending at least partially into the slot,
               wherein rotation of the threaded member in a first direction is configured to drive the actuation member in a first direction along the threaded member to drive the arm portion to pivot away from the outer portion of the coaptation member toward an open position, and   wherein rotation of the threaded member in a second direction is configured to drive the actuation member in a second direction along the threaded member to drive the arm portion to pivot toward the outer portion of the coaptation member toward a closed position.   
               
               

     14. The valve repair device of example 13, further comprising an attachment member coupled to the back member between the back member and the arm portion, wherein the attachment member is secured to the coaptation member. 
     15. The valve repair device of example 14 wherein the attachment member is secured to the coaptation member via suturing. 
     16. The clip assembly of example 14 or example 15 wherein, when the arm portion is in the closed position—
         the attachment member is separated from the arm portion by a gap, and   the gap has a generally uniform dimension along a length of the arm portion.       

     17. The valve repair device of any one of examples 13-16, further comprising a plurality of cleats extending downward from the coaptation member relative to the flow axis and toward the clip member. 
     18. A valve repair device for repairing a cardiac valve including a first native leaflet and a second native leaflet opposite the first native leaflet, the valve repair device comprising:
         a coaptation member comprising (a) an inner portion having a coaptation surface configured to coapt with the first native leaflet during systole and (b) an outer portion configured to displace at least a portion of the second native leaflet;   an atrial-fixation member comprising a plurality of interconnected struts having a curved shape about a flow axis of the cardiac valve, wherein the atrial-fixation member is configured to press against cardiac tissue above the first native leaflet proximate to a native valve annulus of the cardiac valve; and   a pair of arm members extending between the coaptation member and the atrial-fixation member, wherein the arm members each have (a) a first portion that extends upward from the coaptation member relative to the flow axis and (b) a second portion extending from the first portion that curves downward toward the atrial-fixation member relative to the flow axis.       

     19. The valve repair device of example 18 wherein the arm members each comprise a nitinol strut. 
     20. The valve repair device of example 18 or example 19 wherein the arm members each comprise a pair of elongate first struts connected by a plurality of interconnected second struts having a diamond-like shape. 
     21. The valve repair device of any one of examples 18-20 wherein the atrial-fixation member is configured not to press against cardiac tissue above the second native leaflet proximate to the native valve annulus. 
     22. The valve repair device of any one of examples 18-21 wherein the brim portion is positioned above the coaptation surface along the flow axis. 
     23. The valve repair device of any one of examples 18-22 wherein the brim portion includes a plurality of cleats extending upward relative to the flow axis. 
     24. The valve repair device of any one of examples 18-23 wherein the coaptation member includes a brim portion configured to press against cardiac tissue above the second native leaflet proximate to the native valve annulus. 
     25. The valve repair device of any one of examples 18-24 wherein the coaptation member includes (a) a first side portion between the inner portion and the outer portion and (b) a second side portion, opposite the first side portion, between the inner portion and the outer portion, wherein the first portion of a first one of the arm members is coupled to the coaptation member proximate to the first side portion of the coaptation member, and wherein the first portion of a second one of the connection portions is coupled to the coaptation member proximate to the second side portion of the coaptation member. 
     26. The valve repair device of any one of examples 18-25, further comprising:
         a clip assembly coupled to the coaptation member and configured to secure the second native leaflet, wherein the clip assembly comprises:
           a back member;   a clip member having an arm portion and a root portion, wherein the root portion is pivotably coupled to the back member, and wherein the root portion defines a slot;   a threaded member coupled to the back member and configured to rotate relative to the back member; and   an actuation member coupled to the threaded member, wherein the actuation member includes a projection extending at least partially into the slot,
               wherein rotation of the threaded member in a first direction is configured to drive the actuation member in a first direction along the threaded member to drive the arm portion to pivot away from the outer portion of the coaptation member toward an open position, and   wherein rotation of the threaded member in a second direction is configured to drive the actuation member in a second direction along the threaded member to drive the arm portion to pivot toward the outer portion of the coaptation member toward a closed position.   
               
               

     27. The valve repair device of example 26, further comprising an attachment member coupled to the back member between the back member and the arm portion, wherein the attachment member is secured to the coaptation member. 
     28. The valve repair device of example 27 wherein the attachment member is secured to the coaptation member via suturing. 
     29. The clip assembly of example 27 or example 28 wherein, when the arm portion is in the closed position—
         the attachment member is separated from the arm portion by a gap, and   the gap has a generally uniform dimension along a length of the arm portion.       

     30. The valve repair device of any one of examples 26-29, further comprising a plurality of cleats extending downward from the coaptation member relative to the flow axis and toward the clip member. 
     31. A clip assembly for securing a native leaflet of a cardiac valve, the clip assembly comprising:
         a back member;   a clip member having an arm portion and a root portion, wherein the root portion is pivotably coupled to the back member, and wherein the root portion defines a slot;   a threaded member coupled to the back member and configured to rotate relative to the back member; and   an actuation member coupled to the threaded member, wherein the actuation member includes a projection extending at least partially into the slot,
           wherein rotation of the threaded member in a first direction is configured to drive the actuation member in a first direction along the threaded member to drive the arm portion to pivot away from the back member toward an open position, and   wherein rotation of the threaded member in a second direction is configured to drive the actuation member in a second direction along the threaded member to drive the arm portion to pivot toward the back member toward a closed position.   
               

     32. The clip assembly of example 31 wherein the actuation member is a nut. 
     33. The clip assembly of example 31 or example 32, further comprising an attachment member coupled to the back member between the back member and the arm portion. 
     34. The clip assembly of example 33 wherein the attachment member includes a body portion and a plurality of finger portions extending from the body portion, and wherein two or more of the finger portions are configured to be secured to a coaptation member configured to displace at least a portion of the native leaflet. 
     35. The clip assembly of example 33 or example 34 wherein the attachment member has a planform shape that generally matches a planform shape of the arm portion. 
     36. The clip assembly of any one of examples 33-35 wherein the arm portion has a first flat segment and a first curved segment, wherein the attachment member has a second flat segment and a second curved segment, and wherein, when the arm portion is in the closed position, (a) the first flat segment is positioned adjacent to and generally parallel to the second flat segment and (b) the first curved segment is positioned adjacent to and generally parallel to the second curved segment. 
     37. The clip assembly of any one of examples 33-36 wherein, when the arm portion is in the closed position—
         the attachment member is separated from the arm portion by a gap, and   the gap has a generally uniform dimension along a length of the arm portion.       

     38. A valve repair device for repairing a cardiac valve, the valve repair device comprising:
         a coaptation member comprising (a) an inner portion having a coaptation surface configured to coapt with a first native leaflet during systole, (b) an outer portion configured to displace at least a portion of a second native leaflet opposing the first native leaflet, and (c) a brim portion configured to engage cardiac tissue only in a region superior to the second native leaflet proximate to the native valve annulus; and   an atrial-fixation member coupled to coaptation member, wherein the atrial-fixation member is configured to engage cardiac tissue only in a region superior to the first native leaflet, and wherein the atrial-fixation member and the brim portion cooperate to maintain the coaptation member in a substantially stationary position during cardiac cycles.       

     39. The valve repair device of example 38 wherein the atrial-fixation member is configured not to press against cardiac tissue superior to the second native leaflet. 
     40. The valve repair device of example 38 or example 39 wherein the brim portion comprises a plurality of interconnected struts covered with a biocompatible material. 
     41. The valve repair device of any one of examples 38-40 wherein the brim portion has a shape that curves in a direction away from the atrial-fixation member back toward the atrial-fixation member. 
     42. The valve repair device of any one of examples 38-41 wherein the coaptation member comprises a plurality of interconnected struts defining the brim portion and a hollow interior volume within the coaptation member, and wherein the struts are covered with a biocompatible material. 
     43. The valve repair device of any one of examples 38-42, further comprising two or more cleats extending from the brim portion downward relative to a flow axis of the cardiac valve and configured to engage the cardiac tissue superior to the second native leaflet proximate to the native valve annulus. 
     The above detailed description of embodiments of the technology are not intended to be exhaustive or to limit the technology to the precise form disclosed above. Although specific embodiments of, and examples for, the technology are described above for illustrative purposes, various equivalent modifications are possible within the scope of the technology as those skilled in the relevant art will recognize. For example, although steps are presented in a given order, alternative embodiments can perform steps in a different order. The various embodiments described herein can also be combined to provide further embodiments. 
     From the foregoing, it will be appreciated that specific embodiments of the technology have been described herein for purposes of illustration, but well-known structures and functions have not been shown or described in detail to avoid unnecessarily obscuring the description of the embodiments of the technology. Where the context permits, singular or plural terms can also include the plural or singular term, respectively. 
     Moreover, unless the word “or” is expressly limited to mean only a single item exclusive from the other items in reference to a list of two or more items, then the use of “or” in such a list is to be interpreted as including (a) any single item in the list, (b) all of the items in the list, or (c) any combination of the items in the list. Additionally, the term “comprising” is used throughout to mean including at least the recited feature(s) such that any greater number of the same feature and/or additional types of other features are not precluded. It will also be appreciated that specific embodiments have been described herein for purposes of illustration, but that various modifications can be made without deviating from the technology. Further, while advantages associated with some embodiments of the technology have been described in the context of those embodiments, other embodiments can also exhibit such advantages, and not all embodiments need necessarily exhibit such advantages to fall within the scope of the technology. Accordingly, the disclosure and associated technology can encompass other embodiments not expressly shown or described herein.