Patent Publication Number: US-2021161668-A1

Title: Native valve repair devices and procedures

Description:
RELATED APPLICATION 
     The present application is a continuation application of U.S. patent application Ser. No. 16/924,163, filed on Jul. 8, 2020, which is a continuation application of International Application No. PCT/US2019/012707, filed on Jan. 8, 2019 which claims the benefit of U.S. Provisional Application No. 62/615,213, filed on Jan. 9, 2018, titled “Native Valve Repair Devices and Procedures.” Each of the foregoing applications is incorporated herein by reference in its entirety for all purposes. 
    
    
     FIELD OF THE INVENTION 
     The present application relates generally to prosthetic devices and related methods for helping to seal native heart valves and prevent or reduce regurgitation therethrough, as well as devices and related methods for implanting such prosthetic devices. 
     BACKGROUND OF THE INVENTION 
     The native heart valves (i.e., the aortic, pulmonary, tricuspid, and mitral valves) serve critical functions in assuring the forward flow of an adequate supply of blood through the cardiovascular system. These heart valves can be damaged, and thus rendered less effective, by congenital malformations, inflammatory processes, infectious conditions, or disease. Such damage to the valves can result in serious cardiovascular compromise or death. For many years the definitive treatment for such damaged valves was surgical repair or replacement of the valve during open heart surgery. However, open heart surgeries are highly invasive and are prone to many complications. Therefore, elderly and frail patients with defective heart valves often went untreated. More recently, transvascular techniques have been developed for introducing and implanting prosthetic devices in a manner that is much less invasive than open heart surgery. One particular transvascular technique that is used for accessing the native mitral and aortic valves is the trans-septal technique. The trans septal technique comprises inserting a catheter into the right femoral vein, up the inferior vena cava and into the right atrium. The septum is then punctured, and the catheter passed into the left atrium. 
     A healthy heart has a generally conical shape that tapers to a lower apex. The heart is four-chambered and comprises the left atrium, right atrium, left ventricle, and right ventricle. The left and right sides of the heart are separated by a wall generally referred to as the septum. The native mitral valve of the human heart connects the left atrium to the left ventricle. The mitral valve has a very different anatomy than other native heart valves. The mitral valve includes an annulus portion, which is an annular portion of the native valve tissue surrounding the mitral valve orifice, and a pair of cusps, or leaflets, extending downward from the annulus into the left ventricle. The mitral valve annulus can form a “D”-shaped, oval, or otherwise out-of-round cross-sectional shape having major and minor axes. The anterior leaflet can be larger than the posterior leaflet, forming a generally “C”-shaped boundary between the abutting free edges of the leaflets when they are closed together. 
     When operating properly, the anterior leaflet and the posterior leaflet function together as a one-way valve to allow blood to flow only from the left atrium to the left ventricle. The left atrium receives oxygenated blood from the pulmonary veins. When the muscles of the left atrium contract and the left ventricle dilates (also referred to as “ventricular diastole” or “diastole”), the oxygenated blood that is collected in the left atrium flows into the left ventricle. When the muscles of the left atrium relax and the muscles of the left ventricle contract (also referred to as “ventricular systole” or “systole”), the increased blood pressure in the left ventricle urges the two leaflets together, thereby closing the one-way mitral valve so that blood cannot flow back to the left atrium and is instead expelled out of the left ventricle through the aortic valve. To prevent the two leaflets from prolapsing under pressure and folding back through the mitral annulus toward the left atrium, a plurality of fibrous cords called chordae tendineae tether the leaflets to papillary muscles in the left ventricle. 
     Mitral regurgitation occurs when the native mitral valve fails to close properly and blood flows into the left atrium from the left ventricle during the systolic phase of heart contraction. Mitral regurgitation is the most common form of valvular heart disease. Mitral regurgitation has different causes, such as leaflet prolapse, dysfunctional papillary muscles and/or stretching of the mitral valve annulus resulting from dilation of the left ventricle. Mitral regurgitation at a central portion of the leaflets can be referred to as central jet mitral regurgitation and mitral regurgitation nearer to one commissure (i.e., location where the leaflets meet) of the leaflets can be referred to as eccentric jet mitral regurgitation. For central jet regurgitation, the edges of the leaflets do not meet in the middle. Therefore, the valve does not close, and regurgitation is present. 
     Some prior techniques for treating mitral regurgitation in patients include surgically stitching the edges of the native mitral valve leaflets directly to one another. A catheter delivered clip has been used to attempt to clip the edges of the leaflets together like the surgical stitching method. However, this clip has shortcomings, since it can only be used to clip the middle edges of the leaflets where they overlap by 2 mm or more. Alternately, it has been attempted to use multiple clips on the commissures of the mitral valve, where there may be more overlap. This results in a longer operation time and the patient&#39;s leaflets are joined at the sides, restricting blood flow. Both the surgical and clip treatments are thought to create stress on patient leaflets. 
     Despite these prior techniques, there is a continuing need for improved devices and methods for treating mitral valve regurgitation. 
     SUMMARY 
     An exemplary valve repair device for repairing a native valve of a patient includes a pair of paddles, a pair of gripping members, and a spacer element. The paddles are movable between an open position and a closed position. The paddles and the gripping members are configured to attach to the native valve of the patient. The spacer element is configured to close a gap in the native valve of the patient when the valve repair device is attached to the native valve. 
     A further understanding of the nature and advantages of the present invention are set forth in the following description and claims, particularly when considered in conjunction with the accompanying drawings in which like parts bear like reference numerals. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       To further clarify various aspects of embodiments of the present disclosure, a more particular description of the certain embodiments will be made by reference to various aspects of the appended drawings. It is appreciated that these drawings depict only typical embodiments of the present disclosure and are therefore not to be considered limiting of the scope of the disclosure. Moreover, while the figures can be drawn to scale for some embodiments, the figures are not necessarily drawn to scale for all embodiments. Embodiments of the present disclosure will be described and explained with additional specificity and detail using the accompanying drawings. 
         FIG. 1  illustrates a cutaway view of the human heart in a diastolic phase; 
         FIG. 2  illustrates a cutaway view of the human heart in a systolic phase; 
         FIG. 3  illustrates a healthy mitral valve with the leaflets closed as viewed from an atrial side of the mitral valve; 
         FIG. 4  illustrates a dysfunctional mitral valve with a visible gap between the leaflets as viewed from an atrial side of the mitral valve; 
         FIG. 4A  illustrates tricuspid valve viewed from an atrial side of the tricuspid valve; 
         FIG. 5  illustrates a cutaway view of the human heart in a diastolic phase, in which the chordae tendineae are shown attaching the leaflets of the mitral and tricuspid valves to ventricle walls; 
         FIG. 6  illustrates a valve repair device with paddles in an open position; 
         FIG. 7  illustrates the valve repair device of  FIG. 6 , in which the paddles are in the open position and gripping members are moved to create a wider gap between the gripping members and paddles; 
         FIG. 8  illustrates the valve repair device of  FIG. 6 , in which the valve repair device is in the position shown in  FIG. 7  with valve tissue placed between the gripping members and the paddles; 
         FIG. 9  illustrates the valve repair device of  FIG. 6 , in which the gripping members are moved to lessen the gap between the gripping members and the paddles; 
         FIGS. 10A-10B  illustrate the movement of the paddles of the valve repair device of  FIG. 6  from the open position to a closed position; 
         FIG. 11  illustrates the valve repair device of  FIG. 6  in a closed position, in which the gripping members are engaging valve tissue; 
         FIG. 12  illustrates the valve repair device of  FIG. 6  after being disconnected from a delivery device and attached to valve tissue, in which the valve repair device is in a closed and locked condition; 
         FIG. 13A  illustrates an exemplary embodiment of a valve repair device attached to the anterior leaflet and the posterior leaflet of a patient&#39;s mitral valve, shown from the left atrium of the patient&#39;s heart with the valve repair device and leaflet tissue on the ventricular side shown in hidden lines; 
         FIG. 13B  is an enlarged version of  FIG. 13A ; 
         FIG. 14A  is another exemplary embodiment of a valve repair device attached to the anterior leaflet and the posterior leaflet of a patient&#39;s mitral valve with the valve repair device and leaflet tissue on the ventricular side shown in hidden lines; 
         FIG. 14B  is another exemplary embodiment of a valve repair device attached to the anterior leaflet and the posterior leaflet of a patient&#39;s mitral valve, in which the valve repair device includes paddles that flex to place less stress on the mitral valve tissue with the valve repair device and leaflet tissue on the ventricular side shown in hidden lines; 
         FIGS. 15A-15B  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device includes paddles that flex along their length to place less stress on valve tissue when the valve repair device is attached to the valve tissue; 
         FIGS. 16A-16F  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device includes compressible paddles that comprise an exemplary embodiment of a wire loop; 
         FIGS. 16G-16H  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device includes compressible paddles that comprise another exemplary embodiment of a wire loop; 
         FIGS. 16I-16J  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device includes compressible paddles that comprise another exemplary embodiment of a wire loop; 
         FIGS. 17A-17F  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device includes compressible paddles having a horseshoe shape; 
         FIGS. 18A-18D  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device includes compressible paddles having a horseshoe shape; 
         FIGS. 18E and 18F  illustrate a compressible paddle that is similar to the compressible paddle shown in  FIGS. 18C and 18D , except legs of the paddle do not cross when the paddle is loaded into a catheter; 
         FIGS. 19A-19D  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device includes compressible mesh paddles; 
         FIGS. 20A-20B  illustrate an exemplary embodiment of a paddle for a valve repair device, in which the paddle is compressible; 
         FIGS. 21A-21B  illustrate another exemplary embodiment of a valve repair device, in which the paddles of the valve repair device are extendable; 
         FIG. 22  illustrates another exemplary embodiment of a valve repair assembly where a gripper control mechanism is configured to control each gripper member of a valve repair device independently; 
         FIGS. 22A-22D  illustrate another exemplary embodiment of a valve repair assembly where an exemplary embodiment of gripper control mechanism is configured to control four gripper members of an exemplary embodiment of valve repair device independently of each other; 
         FIG. 23  illustrates another exemplary embodiment of a valve repair assembly where a gripper control mechanism is configured to control each gripper member of a valve repair device independently; 
         FIG. 24  illustrates an exemplary embodiment of a connection between a placement shaft and a paddle control mechanism shaft of the valve repair device of  FIG. 23 , in which the gripper control mechanism is attached to the valve repair device at the connection between the placement shaft and the paddle control mechanism shaft; 
         FIGS. 24A-24B  illustrate an exemplary embodiment of a connection between a placement shaft and a paddle control mechanism shaft of the valve repair device of  FIG. 23 , in which the gripper control mechanism is attached to the valve repair device at the connection between the placement shaft and the shaft of the valve repair device. 
         FIG. 25  illustrates another exemplary embodiment of a valve repair assembly in which a gripper control mechanism is configured to control each gripper member of a valve repair device independently of each other; 
         FIG. 25A  illustrates another exemplary embodiment of a gripper control mechanism that is configured to control each gripper member of a valve repair device independently of each other; 
         FIG. 26  illustrates another exemplary embodiment of a valve repair assembly in which a gripper control mechanism is configured to control each gripper member of a valve repair device independently of each other; 
         FIGS. 27A-27C  illustrate another exemplary embodiment of a valve repair device where each paddle of the valve repair device can be independently moved from an open position to a closed position; 
         FIGS. 28A-28F  illustrate another exemplary embodiment of a valve repair device where each paddle of the valve repair device can be independently moved from an open position to a closed position; 
         FIGS. 29A-29B  illustrate another exemplary embodiment of a valve repair device where each paddle of the valve repair device can be independently moved from an open position to a closed position independent of each other; 
         FIG. 30  illustrates a mitral valve having a wide gap between the posterior leaflet and the anterior leaflet; 
         FIGS. 31A-31B  illustrate another exemplary embodiment of a valve repair device, in which the paddles of the valve repair device expand to create a wide gap for receiving valve tissue; 
         FIGS. 32A-32C  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device is configured such that paddles of the valve repair device expand by pivoting and spreading apart to create a wide gap for receiving valve tissue; 
         FIGS. 33A-33C  illustrate another exemplary embodiment of a valve repair device, in which the valve repair device is configured such that paddles of the valve repair device expand by spreading apart and pivoting to create a wide gap for receiving valve tissue; 
         FIGS. 34A-34B  illustrate another exemplary embodiment of a valve repair device, in which a “W”-shaped mechanism expands the paddles of the valve repair device to create a wide gap; 
         FIGS. 34C-34D  illustrate another exemplary embodiment of a valve repair device, in which a “W”-shaped mechanism expands the paddles of the valve repair device to create a wide gap; 
         FIGS. 35A-35B  illustrate another exemplary embodiment of a valve repair device, in which a “W”-shaped mechanism expands paddles of the valve repair device to create a wide gap for receiving valve tissue; 
         FIGS. 36A-36B  illustrate another exemplary embodiment of a valve repair device, in which a “W”-shaped mechanism expands paddles of the valve repair device to create a wide gap; 
         FIG. 36C  illustrate an exemplary embodiment of a paddle control mechanism for the valve repair device of  FIGS. 36A-36B ; 
         FIGS. 36D-36E  illustrate another exemplary embodiment of a valve repair device, in which a “W”-shaped mechanism expands paddles of the valve repair device to create a wide gap; 
         FIGS. 37A-37D  illustrate another exemplary embodiment of a valve repair device with mesh paddles and an internal cam for spreading the mesh paddles apart to create a wide gap for spaced apart valve tissues; 
         FIGS. 37E-37F  illustrate another exemplary embodiment of a valve repair device with mesh paddles and an internal cam for spreading the mesh paddles apart to create a wide gap for spaced apart valve tissues; 
         FIG. 38  illustrates an exemplary embodiment of a valve repair device that includes an exemplary embodiment of a spacer element, in which the valve repair device is attached to a mitral valve; 
         FIG. 39  illustrates another exemplary embodiment of a valve repair device that includes an exemplary embodiment of a spacer element, and in which the valve repair device is attached to a mitral valve; 
         FIGS. 40A-40B  illustrate another exemplary embodiment of a valve repair device that includes an exemplary embodiment of a spacer element, in which the spacer element is attached to a shaft of the valve repair device; 
         FIGS. 41A-41D  illustrate another exemplary embodiment of a valve repair device that includes an exemplary embodiment of a spacer element with a first portion attached to a first gripping member of the valve repair device and a second portion attached to a second gripping member of the valve repair device; 
         FIGS. 42A-42C  illustrate the valve repair device of  FIGS. 40A-40B  with the spacer element having various shapes; 
         FIGS. 43A-43C  illustrate the valve repair device of  FIGS. 41A-41B  with the spacer element having various shapes; 
         FIGS. 44A-44B  illustrate another exemplary embodiment of a valve repair device with paddles that spread wider and an expanding spacer element; 
         FIGS. 45A-45C  illustrate another exemplary embodiment of a valve repair device with an increased bailout angle for removing the valve repair device; 
         FIGS. 46A-46D  illustrate another exemplary embodiment of a valve repair device with an increased bailout angle for removing the valve repair device; 
         FIGS. 47A-47B  illustrate another exemplary embodiment of a valve repair device with an attachment member for connecting the paddles to the grippers when the valve repair device is in a closed position; 
         FIG. 48  illustrates another exemplary embodiment of a valve repair device having a spring member that is configured to bias the paddles of the valve repair device to a closed position; 
         FIG. 49  illustrates another exemplary embodiment of a valve repair device having a threaded mechanism for moving the valve repair device between the open position and the closed position; 
         FIG. 50  illustrates another exemplary embodiment of a valve repair device having gripping members attached to the paddles; 
         FIG. 51  illustrates another exemplary embodiment of a valve repair device having gripping members with a single row of barbs; 
         FIGS. 51A-51E  illustrate another exemplary embodiment of a valve repair system having a valve repair assembly with a valve repair device having gripping members configured to place a tensioning force on valve tissue when the valve repair device is attached to the valve tissue; 
         FIGS. 51F-51H  illustrate another exemplary embodiment of a valve repair assembly having gripping members configured to place a tensioning force on valve tissue when the valve repair device is attached to the valve tissue; 
         FIG. 52  illustrates another exemplary embodiment of a valve repair device having gripping members that are extendable in length; 
         FIGS. 53A-53B  illustrate another exemplary embodiment of a valve repair device having gripping members that are flexible; and 
         FIG. 54  illustrate another exemplary embodiment of a valve repair device, in which gripping members are attached to a separate spring member. 
     
    
    
     DETAILED DESCRIPTION 
     The following description refers to the accompanying drawings, which illustrate specific embodiments of the invention. Other embodiments having different structures and operation do not depart from the scope of the present invention. 
     Exemplary embodiments of the present disclosure are directed to devices and methods for repairing a defective heart valve. It should be noted that various embodiments of native valve reparation devices and systems for delivery are disclosed herein, and any combination of these options can be made unless specifically excluded. In other words, individual components of the disclosed devices and systems can be combined unless mutually exclusive or otherwise physically impossible. 
       FIGS. 1 and 2  are cutaway views of the human heart H in diastolic and systolic phases, respectively. The right ventricle RV and left ventricle LV are separated from the right atrium RA and left atrium LA, respectively, by the tricuspid valve TV and mitral valve MV; i.e., the atrioventricular valves. Additionally, the aortic valve AV separates the left ventricle LV from the ascending aorta AA, and the pulmonary valve PV separates the right ventricle from the pulmonary artery PA. Each of these valves has flexible leaflets (e.g., leaflets  302 ,  304  shown in  FIGS. 3 and 4 ) extending inward across the respective orifices that come together or “coapt” in the flowstream to form the one-way, fluid-occluding surfaces. The native valve repair systems of the present application are described primarily with respect to the mitral valve MV. Therefore, anatomical structures of the left atrium LA and Left ventricle LV will be explained in greater detail. It should be understood that the devices described herein may also be used in repairing other native valves, e.g., the devices can be used in repairing the tricuspid valve TV, the aortic valve AV, and the pulmonary valve PV. 
     The left atrium LA receives oxygenated blood from the lungs. During the diastolic phase, or diastole, seen in  FIG. 1 , the blood that was previously collected in the left atrium LA (during the systolic phase) moves through the mitral valve MV and into the left ventricle LV by expansion of the left ventricle LV. In the systolic phase, or systole, seen in  FIG. 2 , the left ventricle LV contracts to force the blood through the aortic valve AV and ascending aorta AA into the body. During systole, the leaflets of the mitral valve MV close to prevent the blood from regurgitating from the left ventricle LV and back into the left atrium LA, and blood is collected in the left atrium from the pulmonary vein. In one exemplary embodiment, the devices described by the present application are used to repair the function of a defective mitral valve MV. That is, the devices are configured to help close the leaflets of the mitral valve to prevent blood from regurgitating from the left ventricle LV and back into the left atrium LA. 
     Referring to  FIGS. 1-5 , the mitral valve MV includes two leaflets, the anterior leaflet  302  and the posterior leaflet  304 . The mitral valve MV also includes an annulus  306 , which is a variably dense fibrous ring of tissues that encircles the leaflets  302 ,  304 . Referring to  FIG. 5 , the mitral valve MV is anchored to the wall of the left ventricle LV by chordae tendineae  501 . The chordae tendineae  501  are cord-like tendons that connect the papillary muscles  503  (i.e., the muscles located at the base of the chordae tendineae and within the walls of the left ventricle) to the leaflets  302 ,  304  of the mitral valve MV. The papillary muscles serve to limit the movements of the mitral valve MV and prevent the mitral valve from being reverted. The mitral valve MV opens and closes in response to pressure changes in the left atrium LA and the left ventricle LV. The papillary muscles do not open or close the mitral valve MV. Rather, the papillary muscles brace the mitral valve MV against the high pressure needed to circulate blood throughout the body. Together the papillary muscles and the chordae tendineae are known as the subvalvular apparatus, which functions to keep the mitral valve MV from prolapsing into the left atrium LA when the mitral valve closes. 
     Various disease processes can impair proper function of one or more of the native valves of the heart H. These disease processes include degenerative processes (e.g., Barlow&#39;s Disease, fibroelastic deficiency), inflammatory processes (e.g., Rheumatic Heart Disease), and infectious processes (e.g., endocarditis). In addition, damage to the left ventricle LV or the right ventricle RV from prior heart attacks (i.e., myocardial infarction secondary to coronary artery disease) or other heart diseases (e.g., cardiomyopathy) can distort a native valve&#39;s geometry, which can cause the native valve to dysfunction. However, the vast majority of patients undergoing valve surgery, such as surgery to the mitral valve MV, suffer from a degenerative disease that causes a malfunction in a leaflet (e.g., leaflets  302 ,  304 ) of a native valve (e.g., the mitral valve MV), which results in prolapse and regurgitation. 
     Generally, a native valve may malfunction in two different ways. One possible malfunction is valve stenosis, which occurs when a native valve does not open completely and thereby causes an obstruction of blood flow. Typically, valve stenosis results from buildup of calcified material on the leaflets of a valve, which causes the leaflets to thicken and impairs the ability of the valve to fully open to permit forward blood flow. 
     Another possible malfunction is valve regurgitation, which occurs when the leaflets of the valve do not close completely thereby causing blood to leak back into the prior chamber (e.g., causing blood to leak from the left ventricle to the left atrium). There are three mechanisms by which a native valve becomes regurgitant or incompetent, which include Carpentier&#39;s type I, type II, and type III malfunctions. A Carpentier type 1 malfunction involves the dilation of the annulus such that normally functioning leaflets are distracted from each other and fail to form a tight seal (i.e., do not coapt properly). Included in a type I mechanism malfunction are perforations of the leaflets, as in endocarditis. A Carpentier&#39;s type II malfunction involves prolapse of one or more leaflets of a native valve above a plane of coaption. A Carpentier&#39;s type III malfunction involves restriction of the motion of one or more leaflets of a native valve such that the leaflets are abnormally constrained below the plane of the annulus. Leaflet restriction can be caused by rheumatic disease (Ma) or dilation of a ventricle (Mb). 
     Referring to  FIG. 3 , when a healthy mitral valve MV is in a closed position, the anterior leaflet  302  and the posterior leaflet  304  coapt, which prevents blood from leaking from the left ventricle LV to the left atrium LA. Referring to  FIG. 4 , regurgitation occurs when the anterior leaflet  302  and/or the posterior leaflet  304  of the mitral valve MV is displaced into the left atrium LA during systole. This failure to coapt causes a gap  408  between the anterior leaflet  302  and the posterior leaflet  304 , which allows blood to flow back into the left atrium LA from the left ventricle LV during systole. As set forth above, there are several different ways that a leaflet (e.g. leaflets  302 ,  304  of mitral valve MV) may malfunction, which can thereby lead to regurgitation. 
     Although stenosis or regurgitation can affect any valve, stenosis is predominantly found to affect either the aortic valve AV or the pulmonary valve PV, and regurgitation is predominantly found to affect either the mitral valve MV or the tricuspid valve TV. Both valve stenosis and valve regurgitation increase the workload of the heart H and may lead to very serious conditions if left un-treated; such as endocarditis, congestive heart failure, permanent heart damage, cardiac arrest, and ultimately death. Because the left side of the heart (i.e., the left atrium LA, the left ventricle LV, the mitral valve MV, and the aortic valve AV) is primarily responsible for circulating the flow of blood throughout the body, malfunction of the mitral valve MV or the aortic valve AV is particularly problematic and often life threatening. Accordingly, because of the substantially higher pressures on the left side of the heart, dysfunction of the mitral valve MV or the aortic valve AV is much more problematic. 
     Malfunctioning native heart valves may either be repaired or replaced. Repair typically involves the preservation and correction of the patient&#39;s native valve. Replacement typically involves replacing the patient&#39;s native valve with a biological or mechanical substitute. Typically, the aortic valve AV and pulmonary valve PV are more prone to stenosis. Because stenotic damage sustained by the leaflets is irreversible, the most conventional treatments for a stenotic aortic valve or stenotic pulmonary valve are removal and replacement of the valve with a surgically implanted heart valve, or displacement of the valve with a transcatheter heart valve. The mitral valve MV and the tricuspid valve TV are more prone to deformation of leaflets, which, as described above, prevents the mitral valve or tricuspid valve from closing properly and allows for regurgitation or back flow of blood from the ventricle into the atrium (e.g., a deformed mitral valve MV may allow for regurgitation or back flow from the left ventricle LV to the left atrium LA). The regurgitation or back flow of blood from the ventricle to the atrium results in valvular insufficiency. Deformations in the structure or shape of the mitral valve MV or the tricuspid valve TV are often repairable. In addition, regurgitation can occur due to the chordae tendineae  501  becoming dysfunctional (e.g., the chordae tendineae may stretch or rupture), which allows the anterior leaflet  302  and the posterior leaflet  304  to be reverted such that blood is regurgitated into the left atrium LA. The problems occurring due to dysfunctional chordae tendineae  501  can be repaired by repairing the chordae tendineae or the structure of the mitral valve (e.g., by securing the leaflets  302 ,  304  at the affected portion of the mitral valve). 
     The devices and procedures disclosed herein make reference to repairing the structure of a mitral valve. However, it should be understood that the devices and concepts provided herein can be used to repair any native valve, as well as any component of a native valve. Referring to  FIG. 4A , any of the devices and concepts provided herein can be used to repair the tricuspid valve TV. For example, any of the devices and concepts provided herein can be used between any two of the anterior leaflet  4011 , septal leaflet  4012 , and posterior leaflet  4013  to prevent regurgitation of blood from the right ventricle into the right atrium. In addition, any of the devices and concepts provided herein can be used on all three of the leaflets  4011 ,  4012 ,  4013  together to prevent regurgitation of blood from the right ventricle to the right atrium. That is, the valve repair devices provided herein can be centrally located between the three leaflets  4011 ,  4012 ,  4013 . 
       FIGS. 6-13B  illustrate a valve repair system  600  for repairing a native valve of a patient. The valve repair system  600  includes a delivery device  601  and a valve repair device  602 , in which delivery device is configured to deliver the valve repair device to the native valve of a patient, and in which the valve repair device is configured to attach to leaflets of a native valve to repair the native valve of the patient. The delivery device  601  can take any suitable form that is capable of delivering the valve repair device  602  to the native valve of a patient. In certain embodiments, the valve repair system  600  is configured to deliver the valve repair device  602  to a native valve of a patient during a non-open-heart procedure. Suitable delivery means for percutaneously delivering the valve repair system  600  in a minimal-invasive procedure, can be delivery sleeves or delivery catheters which may be inserted through small incisions in the skin of a patient and advanced to the implantation site, for example along an endovascular (e.g. transfemoral) path or a transapical path. 
     The valve repair device  602  includes a base assembly  604 , a pair of paddles  606 , and a pair of gripping members  608 . In one exemplary embodiment, the paddles  606  can be integrally formed with the base assembly. For example, the paddles  606  can be formed as extensions of links of the base assembly. In the illustrated example, the base assembly  604  of the valve repair device  602  has a shaft  603 , a coupler  605  configured to move along the shaft, and a lock  607  configured to lock the coupler in a stationary position on the shaft. The coupler  605  is mechanically connected to the paddles  606 , such that movement of the coupler  605  along the shaft  603  causes the paddles to move between an open position and a closed position. In this way, the coupler  605  serves as means for mechanically coupling the paddles  606  to the shaft  603  and, when moving along the shaft  603 , for causing the paddles  606  to move between their open and closed positions. In certain embodiments, the gripping members  608  are pivotally connected to the base assembly  604  (e.g., the gripping members  608  can be pivotally connected to the shaft  603 , or any other suitable member of the base assembly), such that the gripping members can be moved to adjust the width of the opening  614  between the paddles  606  and the gripping members  608 . The gripping member  608  can include a barbed portion  609  for attaching the gripping members to valve tissue when the valve repair device  602  is attached to the valve tissue. The gripping member  608  forms a means for gripping the valve tissue (in particular tissue of the valve leaflets) with a sticking means or portion such as the barbed portion  609 . When the paddles  606  are in the closed position, the paddles engage the gripping members  608 , such that, when valve tissue is attached to the barbed portion  609  of the gripping members, the paddles act as holding or securing means to hold the valve tissue at the gripping members and to secure the valve repair device  602  to the valve tissue. In some embodiments, the gripping members  608  are configured to engage the paddles  606  such that the barbed portion  609  engages the valve tissue member and the paddles  608  to secure the valve repair device  602  to the valve tissue member. For example, in certain situations, it may be advantageous to have the paddles  606  maintain an open position and have the gripping members  608  move outward toward the paddles  606  to engage a valve tissue member and the paddles  606 . 
     While the embodiment shown in  FIGS. 6-13B  illustrate a pair of paddles  606  and a pair of gripping members  608 , it should be understood that the valve repair device  602  can include any suitable number of paddles and gripping members. In certain embodiments, the valve repair system  600  includes a placement shaft  613  that is removably attached to the shaft  603  of the base assembly  604  of the valve repair device  602 . After the valve repair device  602  is secured to valve tissue, the placement shaft  613  is removed from the shaft  603  to remove the valve repair device  602  from the remainder of the valve repair system  600 , such that the valve repair device  602  can remain attached to the valve tissue, and the delivery device  601  can be removed from a patient&#39;s body. 
     The valve repair system  600  can also include a paddle control mechanism  610 , a gripper control mechanism  611 , and a lock control mechanism  612 . The paddle control mechanism  610  is mechanically attached to the coupler  605  to move the coupler along the shaft, which causes the paddles  606  to move between the open and closed positions. The paddle control mechanism  610  can take any suitable form, such as, for example, a shaft or rod. For example, the paddle control mechanism can comprise a hollow shaft, a catheter tube or a sleeve that fits over the placement shaft  613  and the shaft  603  and is connected to the coupler  605 . The gripper control mechanism  611  is configured to move the gripping members  608  such that the width of the opening  614  between the gripping members and the paddles  606  can be altered. The gripper control mechanism  611  can take any suitable form, such as, for example, a line, a suture or wire, a rod, a catheter, etc. 
     The lock control mechanism  612  is configured to lock and unlock the lock. The lock  607  serves as locking means for locking the coupler  605  in a stationary position with respect to the shaft  603  and can take a wide variety of different forms and the type of lock control mechanism  612  may be dictated by the type of lock used. In one embodiment, the lock  607  takes the form of locks often used in caulk guns. That is, the lock  607  includes a pivotable plate having a hole, in which the shaft  603  of the valve repair device  602  is disposed within the hole of the pivotable plate. In this embodiment, when the pivotable plate is in the tilted position, the pivotable plate engages the shaft  603  to maintain a position on the shaft  603 , but, when the pivotable plate is in a substantially non-tilted position, the pivotable plate can be moved along the shaft (which allows the coupler  605  to move along the shaft  603 ). In other words, the coupler  605  is prevented from moving in the direction Y (as shown in  FIG. 10A ) along the shaft  603  when pivotable plate of the lock  607  is in a tilted (or locked) position, and the coupler is allowed to move in the direction Y along the shaft  603  when the pivotable plate is in a substantially non-tilted (or unlocked) position. In embodiments in which the lock  607  includes a pivotable plate, the lock control mechanism  612  is configured to engage the pivotable plate to move the plate between the tilted and substantially non-tilted positions. The lock control mechanism  612  can be, for example, a rod, a suture, a wire, or any other member that is capable of moving a pivotable plate of the lock  607  between a tilted and substantially non-tilted position. In certain embodiments, the pivotable plate of the lock  607  is biased in the tilted (or locked) position, and the lock control mechanism  612  is used to move the plate from the titled position to the substantially non-tilted (or unlocked) position. In other embodiments, the pivotable plate of the lock  607  is biased in the substantially non-tilted (or unlocked) position, and the lock control mechanism  612  is used to move the plate from the substantially non-tilted position to the tilted (or locked) position. 
       FIGS. 10A-10B  illustrate the valve repair device  602  moving from an open position (as shown in  FIG. 10A ) to a closed position (as shown in  FIG. 10B ). The base assembly  604  includes a first link  1021  extending from point A to point B, a second link  1022  extending from point A to point C, a third link  1023  extending from point B to point D, a fourth link  1024  extending from point C to point E, and a fifth link  1025  extending from point D to point E. The coupler  605  is movably attached to the shaft  603 , and the shaft  603  is fixed to the fifth link  1025 . The first link  1021  and the second link  1022  are pivotally attached to the coupler  605  at point A, such that movement of the coupler  605  along the shaft  603  moves the location of point A and, consequently, moves the first link  1021  and the second link  1022 . The first link  1021  and the third link  1023  are pivotally attached to each other at point B, and the second link  1022  and the fourth link  1024  are pivotally attached to each other at point C. One paddle  606   a  is attached to first link  1021  such that movement of first link  1021  causes the paddle  606   a  to move, and the other paddle  606   b  is attached to the second link  1022  such that movement of the second link  1022  causes the paddle  606   b  to move. Alternatively, the paddles  606   a ,  606   b  can be connected to links  1023 ,  1024  or be extensions of links  1023 ,  1024 . 
     In order to move the valve repair device from the open position (as shown in  FIG. 10A ) to the closed position (as shown in  FIG. 10B ), the coupler  605  is moved along the shaft  603  in the direction Y, which moves the pivot point A for the first links  1021  and the second link  1022  to a new position. Movement of the coupler  605  (and pivot point A) in the direction Y causes a portion of the first link  1021  near point A to move in the direction H, and the portion of the first link  1021  near point B to move in the direction J. The paddle  606   a  is attached to the first link  1021  such that movement of the coupler  605  in the direction Y causes the paddle  606   a  to move in the direction Z. In addition, the third link  1023  is pivotally attached to the first link  1021  at point B such that movement of the coupler  605  in the direction Y causes the third link  1023  to move in the direction K. Similarly, movement of the coupler  605  (and pivot point A) in the direction Y causes a portion of the second link  1022  near point A to move in the direction L, and the portion of the second link  1022  near point C to move in the direction M. The paddle  606   b  is attached to the second link  1022  such that movement of the coupler  605  in the direction Y causes the paddle  606   b  to move in the direction V. In addition, the fourth link  1024  is pivotally attached to the second link  1022  at point C such that movement of the coupler  605  in the direction Y causes the fourth link  1024  to move in the direction N.  FIG. 10B  illustrates the final position of the valve repair device  602  after the coupler  605  is moved as shown in  FIG. 10A . 
     Referring to  FIG. 7 , the valve repair device  602  is shown in the open position (similar to the position shown in  FIG. 10A ), and the gripper control mechanism  611  is shown moving the gripping members  608  to provide a wider gap at the opening  614  between the gripping members and the paddles  606 . In the illustrated embodiment, the gripper control mechanism  611  includes a line, such as a suture, a wire, etc. that is threaded through an opening in an end of the gripper members  608 . Both ends of the line extending through the delivery opening  716  of the delivery device  601 . When the line is pulled through the delivery opening  716  in the direction Y, the gripping members  608  move inward in the direction X, which causes the opening  614  between the gripping members and the paddles  606  to become wider. 
     Referring to  FIG. 8 , the valve repair device  602  is shown such that valve tissue  820  is disposed in the opening  614  between the gripping members  608  and the paddles  606 . Referring to  FIG. 9 , after the valve tissue  820  is disposed between the gripping members  608  and the paddles  606 , the gripper control mechanism  611  is used to lessen the width of the opening  614  between the gripping members and the paddles. That is, in the illustrated embodiment, the line of the gripper control mechanism  611  is released from or pushed out of the opening  716  of the delivery member in the direction H, which allows the gripping members  608  to move in the direction D to lessen the width of the opening  614 . While the gripper control mechanism  611  is shown moving the gripping members  608  to increase the width of the opening  614  between the gripping members and the paddles  606  ( FIG. 8 ), it should be understood that the gripping members may not need to be moved in order to position valve tissue in the opening  614 . In certain circumstances, however, the opening  614  between the paddles  606  and the gripping members  608  may need to be wider in order to receive the valve tissue. 
     Referring to  FIG. 11 , the valve repair device  602  is in the closed position and secured to valve tissue  820 . The valve repair device  602  is secured to the valve tissue  820  by the paddles  606   a ,  606   b  and the gripping members  608   a ,  608   b . In particular, the valve tissue  820  is attached to the valve repair device  602  by the barbed portion  609  of the gripping members  608   a ,  608   b , and the paddles  606   a ,  606   b  engage the gripping members  608  to secure the valve repair device  602  to the valve tissue  820 . In order to move the valve repair device  602  from the open position to the closed position, the lock  607  is moved to an unlocked condition (as shown in  FIG. 11 ) by the lock control mechanism  612 . Once the lock  607  is in the unlocked condition, the coupler  605  can be moved along the shaft  603  by the paddle control mechanism  610 . In the illustrated embodiment, the paddle control mechanism  610  moves the coupler  605  in a direction Y along the shaft, which causes one paddle  606   a  to move in a direct X and the other paddle  606   b  to move in a direction Z. The movement of the paddles  606   a ,  606   b  in the direction X and the direction Z, causes the paddles to engage the gripping members  608   a ,  608   b  and secure the valve repair device  602  to the valve tissue  820 . 
     Referring to  FIG. 12 , after the paddles  606  are moved to the closed position to secure the valve repair device  602  to the valve tissue  820  (as shown in  FIG. 11 ), the lock  607  is moved to the locked condition by the locking control mechanism  611  ( FIG. 11 ) to maintain the valve repair device  602  in the closed position. After the valve repair device  602  is maintained in the locked condition by the lock  607 , the valve repair device  602  is removed from the delivery device  601  by disconnecting the shaft  603  from the placement shaft  613  ( FIG. 11 ). In addition, the valve repair device  602  is disengaged from the paddle control mechanism  610  ( FIG. 11 ), the gripper control mechanism  611  ( FIG. 11 ), and the lock control mechanism  612 . Removal of the valve repair device  602  from the delivery device  601  allows the valve repair device to remain secured to valve tissue  820  while the delivery device  601  is removed from a patient. 
     Referring to  FIGS. 13A-13B , the mitral valve  1300  of a patient is shown with a valve repair device  602  attached to the anterior leaflet  1301  and the posterior leaflet  1302  of the mitral valve.  FIGS. 13A-13B  are views from the atrial side of the mitral valve  1300  with portions of the valve repair device  602  and captured mitral valve leaflet tissue on the ventricular side of the mitral valve depicted in hidden lines. During the diastolic phase (as shown in  FIG. 1 ), the blood that collects in the left atrium of the heart enters the mitral valve  1300  by expansion of the left ventricle of the heart. The anterior leaflet  1301  and the posterior leaflet  1302  open to allow blood to travel from the left atrium to the left ventricle. In the systolic phase (as shown in  FIG. 2 ), the left ventricle contracts to force the blood through the aortic valve and the ascending aorta and into the body. During systole, the leaflets of the mitral valve MV close to prevent the blood from regurgitating back into the left atrium LA. As described above, regurgitation of blood from the left ventricle to the left atrium through the mitral valve occurs when the anterior leaflet  1301  and the posterior leaflet  1302  do not close entirely such that a gap exists between the anterior leaflet and the posterior leaflet. In order to repair a mitral valve  1300  to prevent regurgitation of blood through the mitral valve, the valve repair device  602  is connected to the anterior leaflet  1301  and the posterior leaflet  1302  to close the gap. 
     Referring to  FIG. 13A , the mitral valve  1300  is shown from the left atrium of a patient&#39;s heart (e.g., from the view indicated by line A-A in  FIG. 5 ). In the illustrated embodiment, the mitral valve  1300  is shown in an open position (i.e., the position the mitral valve takes during the diastolic phase). The valve repair device  602  is attached to the anterior leaflet  1301  and the posterior leaflet  1302  of the mitral valve  1300  in the left ventricle of the patient&#39;s heart, and is shown in dotted lines in  FIGS. 13A-13B  to indicate the location of the valve repair device with respect to the mitral valve. As shown in  FIGS. 13A-13B , the valve repair device  602  engages the anterior leaflet  1301  and the posterior leaflet  1302  and causes the anterior leaflet and posterior leaflet to engage each other (i.e., the valve repair device closes a portion of the gap between the anterior leaflet and the posterior leaflet). The valve repair device  602  can be placed in a location in which a gap exists between the anterior leaflet  1301  and the posterior leaflet  1302  when the mitral valve  1301  is in a closed position (i.e., the position of the mitral valve during the systolic phase), such that the valve repair device will prevent the gap from occurring. The illustrated embodiment shows the mitral valve  1300  and valve repair device  602  during the diastolic phase. That is, during the diastolic phase, the valve repair device  602  will cause a portion of the mitral valve to remain closed, but the portions of the mitral valve not engaged by the valve repair device will open such that gaps  1303  are created to allow blood to flow from the left atrium to the left ventricle. 
     Referring to  FIG. 13B , the valve repair device  602  is attached to both the anterior leaflet  1301  and the posterior leaflet  1302 . In particular, a portion  1301   a  of the anterior leaflet  1301  is secured between a paddle  606   a  and a gripping member  608   a  of the valve repair device  602 , and a portion  1302   b  of the posterior leaflet  1302  is secured between another paddle  606   b  and another gripping member  608   b  of the valve repair device. The valve repair device  602  is secured and locked to the mitral valve  1300 , for example, as shown in  FIGS. 6-12 . 
       FIGS. 14A-14B  illustrate exemplary embodiments of a valve repair device  602  attached to the anterior leaflet  1301  and posterior leaflet  1302  of a mitral valve  1300 . The mitral valve  1300  is shown from the left atrium of a patient&#39;s heart (e.g., from the view indicated by line A-A in  FIG. 5 ). Still referring to  FIGS. 14A-14B , the valve repair device  602  includes a first paddle  606   a , a second paddle  606   b , a first gripping member  608   a , and a second gripping member  608   b . A portion  1301   a  of the anterior leaflet  1301  is secured between the first paddle  606   a  and the first gripping member  608   a  of the valve repair device  602 , and a portion  1302   b  of the posterior leaflet  1302  is secured between the second paddle  606   b  and the second gripping member  608   b  of the valve repair device. The first and second paddles  606   a ,  606   b  include a main portion  1404  and side portions  1405 . Referring to  FIG. 14A , the valve repair device  602  is configured such that the portions  1301   a ,  1302   b  of the mitral valve  1300  conform to or generally conform to the shape of the paddles  606   a ,  606   b . That is, the valve leaflet portions  1301   a ,  1302   b  are pressed into the paddles by the gripping members  608   a ,  608   b , such that the valve leaflet portions  1301   a ,  1301   b  are disposed along a main portion  1404  and side portions  1405  of the paddles  606   a ,  606   b . In the embodiment of the valve repair device  602  shown in  FIG. 14A , the paddles  606   a ,  606   b  can be made of a rigid material, for example, steel, molded plastic, etc. 
     In the exemplary embodiment illustrated by  FIG. 14B , the paddles  606   a ,  606   b  of the valve repair device  602  are configured to flex. Because of this flex, when the valve repair device is attached to the mitral valve  1300 , the mitral valve tissue portions  1301   a ,  1302   b  move the side portions  1405  of the paddles as indicated by arrows  1450 , which reduces the stress placed on the mitral valve by the valve repair device as compared to the embodiment illustrated by  FIG. 14A . That is, the flexing results in a more gradual contouring of the mitral valve tissue by the paddles, while still securely attaching the valve repair device  602  to the mitral valve tissue. In the embodiment of the valve repair device  602  shown in  FIG. 14B , the paddles  606   a ,  606   b  can be made of a wide variety of different flexible materials or rigid materials that are cut or otherwise processed to provide flexibility. 
       FIGS. 15A-15B  illustrate another exemplary embodiment of a valve repair device  602 . 
     Referring to  FIG. 15A , the valve repair device  602  is in the open position and about to engage valve tissue  820  (e.g., the leaflets of a mitral valve). Referring to  FIG. 15B , the valve repair device  602  is in the closed position and secured to the valve tissue  820 . The valve repair device  602  can take any suitable form, such as, for example, any form described in the present application. The valve repair device  602  can be moved between the open and closed position, and be attached to the valve tissue  820 , by a valve repair system, such as, for example, any valve repair system described in the present application. In the illustrated embodiment, the valve repair device  602  includes paddles  606  and gripping members  608 . The gripping members  608  include a barbed portion  609  for attaching the gripping members to valve tissue  820 . Referring to  FIG. 15A , when the valve repair device  602  is in the open position, the paddles  606  maintain an original form. Referring to  FIG. 15B , upon engagement with the valve tissue  820 , the paddles  606  flex along their length L. That is, a portion of the paddles  606  flex in an inward direction X, and another portion of the paddles extend in an outward direction Z. This flexing of the paddles  606  allows the paddles to conform to the shape of the valve tissue, which places less stress on the valve tissue. 
     Referring to  FIGS. 16A-16F , another exemplary embodiment of a valve repair device  602  includes paddles  606  having a wire loop  1601 . The wire loop  1601  can be made of, for example, any suitable metal material, laser cut loops from a sheet of nitinol, a tube of nitinol, or any other suitable material. In some embodiments, the wire loop  1601  can have varying dimensions throughout the length of the wire loop  1601  to optimize the paddle pinch force and the paddle crimp force on a valve tissue when paddle engages the valve tissue. For example, certain sections of the wire loop  1601  can be thinner than other sections of the wire loop  1601 . In certain embodiments, the wire loop  1601  of the paddles  606  is compressible, which allows the paddles  606  to be disposed in a delivery device  601  (e.g., a catheter) that has a small diameter (as shown in  FIG. 16E ) for delivery of the valve repair device  602  to a native valve of a patient, and also allows the paddles  606  to expand (as shown in  FIGS. 16A-16D ) upon exiting the delivery device  601  such that the paddles  606  have a larger surface area for engaging the native valve of the patient. The valve repair device  602  can take any suitable form, such as, for example, any form described in the present application. The valve repair device  602  can be moved between the open and closed position, and be attached to a native valve, by a valve repair system, such as, for example, any valve repair system described in the present application. 
       FIGS. 16A-16B  illustrate the valve repair device  602  in the open position, and  FIGS. 16C-16D  illustrate the valve repair device in the closed position. Referring to  FIGS. 16A-16B , when the valve repair device  602  is in the expanded and open position, the paddles  606  extend outward to create wide opening  614  between the paddles  606  and gripping members  608  of the valve repair device  602 . Referring to  FIGS. 16C-16D , when the valve repair device  602  is in the expanded and closed position, the paddles  606  engage the gripping members  608  such that valve tissue can be secured between the paddles and the gripping members. The paddles  606  include a curved surface  1603 , which is configured to place less stress on valve tissue when the valve repair device  602  is attached to the valve tissue. When the paddles  606  are in the expanded condition, the paddles have a width W. The width W can be, for example, between about 4 mm and about 21 mm, such as, between about 5 mm and about 20 mm, such as between about 7.5 mm and about 17.5 mm, such as between about 10 mm and about 15 mm. In certain embodiments, the width W can be, for example, 5 mm or more, such as about 7.5 mm or more, such as about 10 mm or more, such as about 15 mm or more, such as about 20 mm or more. In other embodiments, the width W can be less than 5 mm. In certain embodiments, the paddles  606  include a material  1605  disposed over the wire loop  1601  for creating a contact area for the paddles to engage valve tissue. The material  1605  can be any suitable material, such as, for example, a woven material, an electrospun material, or any other material that is capable of promoting tissue ingrowth and protecting liners of the delivery device  601  ( FIG. 6 ) during tracking. In certain embodiments, the material  1605  can be a blood-impermeable cloth, such as a PET cloth or biocompatible covering material such as a fabric that is treated with a coating that is impermeable to blood, polyester, or a processed biological material, such as pericardium. 
     Referring to  FIG. 16E , the paddles  606  are in a compressed condition when the paddles are disposed in a delivery device  601 . When the paddles  606  are in the compressed condition, the paddles have a width H. The width H can be, for example between about 4 mm and about 7 mm, such as, between about 5 mm and about 6 mm. In alternative embodiments, the width H can be less than 4 mm or more than 7 mm. In certain embodiments, the width H of the compressed paddles  606  is substantially equal to a width D of the delivery opening  716  of the delivery device  601 . The ratio between the width W of the paddles in the expanded condition and the width H of the paddles in the compressed condition can be, for example, about 4 to 1 or less, such as about 3 to 1 or less, such as about 2 to 1 or less, such as about 1.5 to 1, such as about 1.25 to 1, such as about 1 to 1. In alternative embodiments, the ratio between the width W and the width H can be more than 4 to 1. Referring to  FIG. 16F , a paddle  606  is moved from the expanded condition to the compressed condition by compressing the paddle in the direction Y and extending a length of the paddle in the direction X. 
       FIGS. 16G-16H  illustrate another exemplary embodiment of a valve repair device  602  in the open position, in which the valve repair device includes paddles  606  having a wire loop  1601 . In the illustrated embodiment, the paddles  606  are shown having a wire loop  1601  that includes three lobes  1611 . Referring to  FIGS. 16I-16J , another exemplary embodiment of a valve repair device  602  includes paddles  606  having a wire loop  1601  with two lobes  1611 . While the embodiments shown in  FIGS. 16G-16H and 16I-16J  show the wire loop  1601  of the paddles  606  having three lobes and two lobes, respectively, it should be understood that the valve repair device  602  can include paddles  606  with a wire loop  1601  having any suitable number of lobes  1611 , such as, for example, two or more lobes, three or more lobes, four or more lobes, five or more lobes, etc. A paddle  606  having a wire loop  1601  having lobes is advantageous because a paddle having lobes can more easily allow chordae tendinae to assume their natural positions than a single wire loop having no lobes. That is, the chordae tendinae can move into spaces between the multiple of loops. 
     The embodiments of the valve repair devices  602  shown in  FIGS. 16G-16H and 16I-16J  can include any of the features described above with reference to  FIGS. 16A-16F . For example, the embodiments of the valve repair devices  602  shown in  FIGS. 16G-16H and 16I-16J  can include a width W, in which the width W can be, for example, between about 4 mm and about 21 mm, such as, between about 5 mm and about 20 mm, such as between about 7.5 mm and about 17.5 mm, such as between about 10 mm and about 15 mm. In certain embodiments, the width W can be, for example, 5 mm or more, such as about 7.5 mm or more, such as about 10 mm or more, such as about 15 mm or more, such as about 20 mm or more. In other embodiments, the width W can be less than 5 mm. The embodiments for the paddles  606  shown in  FIGS. 16G-16H and 16I-16J  can also include a material disposed over the wire loop  1601  for creating a contact area for the paddles to engage valve tissue. The material can be any suitable material, such as, for example, a woven material, an electrospun material, or any other suitable material that is capable of promoting tissue ingrowth and protecting liners of the delivery device  601  ( FIG. 6 ) during tracking. In certain embodiments, the material  1605  can be a blood-impermeable cloth, such as a PET cloth or biocompatible covering material such as a fabric that is treated with a coating that is impermeable to blood, polyester, or a processed biological material, such as pericardium. The embodiments for the paddles  606  shown in  FIGS. 16G-16H and 16I-16J  can also be compressed when disposed in a delivery device  601  (e.g., just as shown in  FIG. 16E  with respect to the embodiment of the paddles  606  shown in  FIGS. 16A-16B ). The ratio between the width W of the paddles  606  in the expanded condition and the width of the paddles in the compressed condition can be, for example, about 4 to 1 or less, such as about 3 to 1 or less, such as about 2 to 1 or less, such as about 1.5 to 1, such as about 1.25 to 1, such as about 1 to 1. In alternative embodiments, the ratio between the width W and the width H can be more than 4 to 1. 
     Referring to  FIGS. 17A-17F , another exemplary embodiment of a valve repair device  602  includes paddles  606  having a horseshoe shape  1701 . In certain embodiments, the horseshoe shape  1701  of the paddles  606  is compressible, which allows the paddles  606  to be disposed in a delivery device  601  (e.g., a catheter) that has a small diameter (as shown in  FIG. 17F ) for delivery of the valve repair device  602  to a native valve of a patient, and also allows the paddles  606  to expand (as shown in  FIGS. 17A-17D ) upon exiting the delivery device  601  such that the paddles  606  have a larger surface area for engaging the native valve of the patient. The valve repair device  602  can take any suitable form, such as, for example, any form described in the present application. The valve repair device  602  can be moved between the open and closed position, and be attached to a native valve, by a valve repair system, such as, for example, any valve repair system described in the present application. 
       FIGS. 17A-17C  illustrate the valve repair device  602  in the open position. Referring to  FIGS. 17A-17B , when the valve repair device  602  is in the expanded and open position, the paddles  606  extend outward to create wide opening  614  between the paddles  606  and gripping members  608  of the valve repair device  602 . In the illustrated embodiment, the horseshoe shape  1701  of the paddles  606  includes side members  1707  that extend from a base  1706  of the paddle  606 , and a center member  1709  that extends from the base  1706  and connects to a base assembly  604  of the valve repair device  602 , in which the side members  1707  form a horseshoe shape as shown in  FIG. 17C , for example. In certain embodiments, the paddles  606  include a material  1705  disposed over the horseshoe shape  1701  for creating a contact area for the paddles to engage valve tissue. The material  1705  can be any suitable material, such as, for example, a woven material, an electrospun material, or any other material that is capable of promoting tissue ingrowth and protecting liners of the delivery device  601  ( FIG. 6 ) during tracking. In certain embodiments, the material  1605  can be a blood-impermeable cloth, such as a PET cloth or biocompatible covering material such as a fabric that is treated with a coating that is impermeable to blood, polyester, or a processed biological material, such as pericardium. 
     In various embodiments, the paddles  606  are configured to flex to place less stress on valve tissue when the valve repair device  602  is attached to the valve tissue. When the paddles  606  are in the expanded condition, the paddles have a width W. The width W can be, for example, between about 4 mm and about 21 mm, such as, between about 5 mm and about 20 mm, such as between about 7.5 mm and about 17.5 mm, such as between about 10 mm and about 15 mm. In certain embodiments, the width W can be, for example, 5 mm or more, such as about 7.5 mm or more, such as about 10 mm or more, such as about 15 mm or more, such as about 20 mm or more. In other embodiments, the width W can be less than 5 mm. Referring to  FIG. 17D , in certain embodiments, the thickness T of the paddle is, for example, between about 0.3 mm and about 0.46 mm, such as between about 0.32 mm and about 0.44 mm, such as between about 0.34 mm and about 0.42 mm, such as between about 0.36 mm and about 0.40 mm, such as about 0.38 mm. In alternative embodiments, the thickness T of the paddle can be less than 0.3 mm or more than 0.46 mm. 
     Referring to  FIG. 17E , the paddles  606  are in a compressed condition when the paddles are disposed in a delivery device  601 . When the paddles  606  are in the compressed condition, the paddles have a width H. The width H can be, for example between about 4 mm and about 7 mm, such as, between about 5 mm and about 6 mm. In alternative embodiments, the width H can be less than 4 mm or more than 7 mm. In certain embodiments, the width H of the compressed paddles  606  is equal to a width D of the delivery opening  716  of the delivery device  601 . The ratio between the width W of the paddles in the expanded condition and the width H of the paddles in the compressed condition can be, for example, about 4 to 1 or less, such as about 3 to 1 or less, such as about 2 to 1 or less, such as about 1.5 to 1, such as about 1.25 to 1, such as about 1 to 1. In alternative embodiments, the ratio between the width W and the width H can be more than 4 to 1. Referring to  FIG. 17F , a paddle  606  is moved from the expanded condition to the compressed condition by compressing the paddle in the direction Y and extending a length of the paddle in the direction X. In the illustrated embodiment, the length of the side members  1707  of the paddle  606  are extended when the paddle is in the compressed condition, but the length of the center member  1709  maintains the same length. 
     Referring to  FIGS. 18A-18D , another exemplary embodiment of a valve repair device  602  includes paddles  606  having another horseshoe shape  1801 . In certain embodiments, the horseshoe shape  1801  of the paddles  606  is compressible, which allows the paddles  606  to be disposed in a delivery device  601  (e.g., a catheter) that has a small diameter (as shown in  FIG. 18C ) for delivery of the valve repair device  602  to a native valve of a patient, and also allows the paddles  606  to expand (as shown in  FIGS. 18A-18B ) upon exiting the delivery device  601  such that the paddles  606  have a larger surface area for engaging the native valve of the patient. The valve repair device  602  can take any suitable form, such as, for example, any form described in the present application. The valve repair device  602  can be moved between the open and closed position, and be attached to a native valve, by a valve repair system, such as, for example, any valve repair system described in the present application. 
       FIGS. 18A-18B  illustrate the valve repair device  602  in the open position. When the valve repair device  602  is in the open position, the paddles  606  extend outward to create wide opening  614  between the paddles  606  and gripping members  608  of the valve repair device  602 . In the illustrated embodiment, the horseshoe shape  1801  of the paddles  606  includes side members  1807  that extend from a base  1806  of the paddle  606 , and the base  1806  is attached to the base assembly  604  of the valve repair device  602 . In certain embodiments, the paddles  606  include a material  1805  disposed over the horseshoe shape  1801  for creating a contact area for the paddles to engage valve tissue. The material  1805  can be any suitable material, such as, for example, a woven material, an electrospun material, or any other material that is capable of promoting tissue ingrowth and protecting liners of the delivery device  601  ( FIG. 6 ) during tracking. In certain embodiments, the material  1605  can be a blood-impermeable cloth, such as a PET cloth or biocompatible covering material such as a fabric that is treated with a coating that is impermeable to blood, polyester, or a processed biological material, such as pericardium. 
     In various embodiments, the paddles  606  are configured to flex to place less stress on valve tissue when the valve repair device  602  is attached to the valve tissue. When the paddles  606  are in the expanded condition, the paddles have a width W. The width W can be, for example, between about 4 mm and about 21 mm, such as, between about 5 mm and about 20 mm, such as between about 7.5 mm and about 17.5 mm, such as between about 10 mm and about 15 mm. In certain embodiments, the width W can be, for example, 5 mm or more, such as about 7.5 mm or more, such as about 10 mm or more, such as about 15 mm or more, such as about 20 mm or more. In other embodiments, the width W can be less than 5 mm. 
     Referring to  FIG. 18C , the paddles  606  are in a compressed condition when the paddles are disposed in a delivery device  601 . When the paddles  606  are in the compressed condition, the paddles have a width H. The width H can be, for example between about 4 mm and about 7 mm, such as, between about 5 mm and about 6 mm. In alternative embodiments, the width H can be less than 4 mm or more than 7 mm. In certain embodiments, the width H of the compressed paddles  606  is equal to a width D of the delivery opening  716  of the delivery device  601 . The ratio between the width W of the paddles in the expanded condition and the width H of the paddles in the compressed condition can be, for example, about 4 to 1 or less, such as about 3 to 1 or less, such as about 2 to 1 or less, such as about 1.5 to 1, such as about 1.25 to 1, such as about 1 to 1. In alternative embodiments, the ratio between the width W and the width H can be more than 4 to 1. Referring to  FIG. 18D , a paddle  606  is moved from the expanded condition to the compressed condition by compressing the paddle in the direction Y and extending a length of the paddle in the direction X. In the illustrated embodiment, the length of the side members  1807  of the paddle  606  are extended when the paddle is in the compressed condition. Referring to  FIG. 18C , in certain embodiments, when the paddles  606  are disposed in the delivery device  601  and in the compressed condition, the side members  1807  of the paddles cross each other. 
     Referring to  FIGS. 19A-19D , another exemplary embodiment of a valve repair device  602  includes paddles  606  having a mesh structure  1901 . In certain embodiments, the mesh structure  1901  of the paddles  606  is compressible, which allows the paddles  606  to be disposed in a delivery device  601  (e.g., a catheter) that has a small diameter (as shown in  FIG. 19C ) for delivery of the valve repair device  602  to a native valve of a patient, and also allows the paddles  606  to expand (as shown in  FIGS. 19A-19B ) upon exiting the delivery device  601  such that the paddles  606  have a larger surface area for engaging the native valve of the patient. The valve repair device  602  can take any suitable form, such as, for example, any form described in the present application. The valve repair device  602  can be moved between the open and closed position, and be attached to a native valve, by a valve repair system, such as, for example, any valve repair system described in the present application. 
       FIGS. 19A-19B  illustrate the valve repair device  602  in the open position. When the valve repair device  602  is in the expanded and open position, the paddles  606  extend outward to create wide opening  614  between the paddles  606  and gripping members  608  of the valve repair device  602 . In certain embodiments, the paddles  606  include a material disposed over the mesh structure  1901 , such as, for example, a woven material, an electrospun material, or any other material that is capable of promoting tissue ingrowth and protecting liners of the delivery device  601  ( FIG. 6 ) during tracking. In certain embodiments, the material  1605  can be a blood-impermeable cloth, such as a PET cloth or biocompatible covering material such as a fabric that is treated with a coating that is impermeable to blood, polyester, or a processed biological material, such as pericardium. 
     In various embodiments, the paddles  606  are configured to flex to place less stress on valve tissue when the valve repair device  602  is attached to the valve tissue. When the paddles  606  are in the expanded condition, the paddles have a width W. The width W can be, for example, between about 4 mm and about 21 mm, such as, between about 5 mm and about 20 mm, such as between about 7.5 mm and about 17.5 mm, such as between about 10 mm and about 15 mm. In certain embodiments, the width W can be, for example, 5 mm or more, such as about 7.5 mm or more, such as about 10 mm or more, such as about 15 mm or more, such as about 20 mm or more. In other embodiments, the width W can be less than 5 mm. 
     Referring to  FIG. 19C , the paddles  606  are in a compressed condition when the paddles are disposed in a delivery device  601 . When the paddles  606  are in the compressed condition, the paddles have a width H. The width H can be, for example between about 4 mm and about 7 mm, such as, between about 5 mm and about 6 mm. In alternative embodiments, the width H can be less than 4 mm or more than 7 mm. In certain embodiments, the width H of the compressed paddles  606  is equal to a width D of the delivery opening  716  of the delivery device  601 . The ratio between the width W of the paddles in the expanded condition and the width H of the paddles in the compressed condition can be, for example, about 4 to 1 or less, such as about 3 to 1 or less, such as about 2 to 1 or less, such as about 1.5 to 1, such as about 1.25 to 1, such as about 1 to 1. In alternative embodiments, the ratio between the width W and the width H can be more than 4 to 1. Referring to  FIG. 19D , a paddle  606  is moved from the expanded condition to the compressed condition by compressing the paddle in the direction Y and extending a length of the paddle in the direction X. 
     Referring to  FIGS. 20A-20B , another exemplary embodiment of a valve repair device includes paddles  606  that are compressible, which allows the paddles  606  to be disposed in a delivery device  601  (e.g., a catheter) that has a small diameter (as shown in  FIG. 20A ) for delivery of the valve repair device to a native valve of a patient, and also allows the paddles  606  to expand (as shown in  FIG. 20B ) upon exiting the delivery device  601  such that the paddles  606  have a larger surface area for engaging the native valve of the patient. The paddles  606  can be included on a valve repair device  602  that takes any suitable form, such as, for example, any form described in the present application. The valve repair device (and paddles  606 ) can be attached to a native valve by a valve repair system, such as, for example, any valve repair system described in the present application. 
       FIG. 20A  illustrates the paddle  606  in a compressed condition inside a delivery device  601 . The paddle includes an opening  2001  that allows a portion of the paddle to expand upon being deployed from the delivery device  601 . In the compressed condition, the paddle  606 , for example, can have a width H between about 4 mm and about 7 mm, such as, between about 5 mm and about 6 mm. In alternative embodiments, the width H can be less than 4 mm or more than 7 mm. In certain embodiments, the width H of the compressed paddles  606  is equal to a width D of the delivery opening  716  of the delivery device  601 .  FIG. 20B  illustrates the paddle  606  in an expanded condition. In the expanded condition, the paddle  606 , for example, can have a width W between about 4 mm and about 21 mm, such as, between about 5 mm and about 20 mm, such as between about 7.5 mm and about 17.5 mm, such as between about 10 mm and about 15 mm. In certain embodiments, the width W can be, for example, 5 mm or more, such as about 7.5 mm or more, such as about 10 mm or more, such as about 15 mm or more, such as about 20 mm or more. In other embodiments, the width W can be less than 5 mm. The ratio between the width W of the paddles in the expanded condition and the width H of the paddles in the compressed condition can be, for example, about 4 to 1 or less, such as about 3 to 1 or less, such as about 2 to 1 or less, such as about 1.5 to 1, such as about 1.25 to 1, such as about 1 to 1. In alternative embodiments, the ratio between the width W and the width H can be more than 4 to 1. Referring to  FIG. 20B , a paddle  606  is moved from the expanded condition to the compressed condition by compressing the paddle in the direction Y. In various embodiments, the paddles  606  are configured to flex to place less stress on valve tissue when the valve repair device  602  is attached to the valve tissue. In certain embodiments, the paddles  606  include a material disposed over the paddle  606 , such as, for example, any material that is capable of promoting tissue ingrowth and protecting liners of the delivery device  601  ( FIG. 6 ) during tracking. In certain embodiments, the material can be a blood-impermeable cloth, such as a PET cloth or biocompatible covering material such as a fabric that is treated with a coating that is impermeable to blood, polyester, or a processed biological material, such as pericardium. 
       FIGS. 21A-21B  illustrate another exemplary embodiment of a valve repair system  600 , in which the valve repair system  600  includes a valve repair device  602  having extendable paddles. The valve repair system  600  can take any suitable form, such as, for example, any form described in the present application. In the illustrated embodiment, the valve repair device  602  includes paddles  606  that are telescoping such that a length L of the paddles can be altered. That is, the paddles  606  include a main portion  2110  and an extendable portion  2112 . The extendable portion  2112  is able to be housed within the main portion  2110  to create paddles having a shorter length L (as shown in  FIG. 21A ), and the extendable portion  2112  is able to be extended outside of the main portion to create paddles having a longer length L (as shown in  FIG. 21B ). The ratio between the shorter length L (as shown in  FIG. 21A ) and the longer length L (as shown in FIG.  21 B) can be, for example, 1.25 to 1 or more, such as 1.5 to 1 or more, such as 2 to 1 or more, such as 2 to 1 or more, such as 4 to 1 or more, such as 5 to 1 or more. 
     In one embodiment, the main portion  2110  is a hollow conduit having an opening, and the extendable portion  2112  is a rod or conduit configured to be housed in the opening of the hollow member. In certain embodiments, the extendable portion  2112  is spring loaded, such that the extendable portion  2112  is biased toward the extended position, and a latch member is disposed in a locked position to maintain the extendable portion  2112  housed within the main portion  2110  in the non-extended position. Movement of the latch member from the locked position to an unlocked position causes the spring-loaded extendable portion  2112  to move outside the main portion  2110  and into the extended position. In addition, the extendable portion  2112  can be moved back within the main portion  2110  and the latch member can be moved from the unlocked position to the locked position to move the paddles from the extended position to the retracted position. The latch member can be moved between the locked an unlocked position by any suitable means, such as, for example, a rod that engages the latch member to move the latch member between the locked and unlocked positions. In an alternative embodiment, a suture or wire extends through the main portion  2110  and engages the extendable portion  2112  to maintain the extendable portion  2112  in the non-extended position, and removal of the suture or wire allows the spring-loaded extendable portion to move outside the main portion  2110  and into the extended position. 
     Referring to  FIG. 21A , the valve repair device  602  is shown with the paddles  606  in a non-extended position, and the valve repair device is positioned to engage valve tissue  820 . Referring to  FIG. 21B , after the valve repair device  602  is placed in position to engage the valve tissue  820 , the extendable portions  2112  of the paddles  606  are extended such that the paddles have a larger surface area for engaging the valve tissue. After the paddles  606  are extended to a desired length L, the valve repair device  602  is closed to secure the valve repair device to the valve tissue  820 , and the valve repair device is removed from the valve repair system  600 . In certain embodiments, the valve repair device  602  is configured such that the extendable portions  2112  of the paddles can be extended or retracted after the valve repair device is secured to the valve tissue  820 , such that the tension on the valve tissue can be increased or decreased depending on the patient and the procedural circumstances. For example, in embodiments in which the valve tissue  820  is a patient&#39;s mitral valve, a valve with excess leaflet material or chordal damage may need more tension to sufficiently seal the mitral valve, or a valve with short non-coapting leaflets may need less tension for a sufficiently seal the mitral valve. The valve repair device can be moved from the open position to a closed position and removed from the valve repair system  600  in any suitable manner, such as, for example, any manner described in the present application. 
     Referring to  FIGS. 22-26 , in certain embodiments, the gripper control mechanism  611  is configured to control each of the gripping members  608  independent of each other. Independent control for each of the gripping members  608  is advantageous because the openings  614  between the paddles  606  and the gripping members can be adjusted independently as the valve repair device  602  is being attached to valve tissue (e.g., a mitral valve of a patient). In addition, independent gripper control will also be advantageous in situations in which one gripping member  608  and one paddle  606  sufficiently secure the valve repair device  602  to a first portion of valve tissue, but the other gripping member and the other paddle fail to connect the valve repair device to a second portion of valve tissue. In this situation, the gripper control mechanism  611  can be used to control only the gripping member  608  that is not connected to the valve tissue to create an opening  614  for receiving the second portion of the valve tissue, and, after the second portion of the valve tissue is disposed in the opening, the unattached gripping member and the unattached paddle can be closed to secure the valve repair device  602  to the second portion of the valve tissue. 
     Still referring to  FIGS. 22-26 , an exemplary embodiment of a valve repair system  600  includes a delivery device  601  and a valve repair device  602 , in which delivery device is configured to deliver the valve repair device to the native valve of a patient, and in which the valve repair device is configured to attach to leaflets of a native valve to repair the native valve of the patient. The delivery device  601  can take any suitable form that is capable of delivering the valve repair device  602  to the native valve of a patient, such as, for example, any form described in the present application. The valve repair device  602  is similar to the previously described valve repair device and includes a base assembly  604 , a pair of paddles  606 , and a pair of gripping members  608 . The base assembly  604  of the valve repair device  602  has a shaft  603 , a coupler  605  configured to move along the shaft, and a lock  607  configured to lock the coupler in a stationary position on the shaft. The valve repair device  602  can take any suitable form, such as, for example, any form described in the present application. The valve repair system  600  can also include a paddle control mechanism  610 , a gripper control mechanism  611 , and a lock control mechanism  612 . The paddle control mechanism  610  is mechanically attached to the coupler  605  to move the coupler along the shaft  603 , which causes the paddles  606  to move between the open and closed positions. The paddle control mechanism  610  can take any suitable form, such as, for example, any form described in the present application. The lock control mechanism  612  is configured to move the coupler  605  between the locked and unlocked conditions. The lock control mechanism  612  can take any suitable form, such as, for example, any form described in the present application. 
     Referring to  FIG. 22 , an exemplary embodiment of a gripper control mechanism  611  includes a first gripper control member  2202  and a second gripper control member  2204 . The first gripper control member  2202  is configured to move the gripping member  608   a  in the direction X, and the second gripper control member  2204  is configured to move the gripping member  608   b  in the direction Z. Movement of the gripping member  608   a  in the direction X will adjust the width W of the opening  614   a  between the gripping member  608   a  and the paddle  606   a , and movement of the gripping member  608   b  in the direction Z will adjust the width H of the opening between the gripping member  608   b  and the paddle  606   b . The gripper control members  2202 ,  2204  can take any suitable form that is capable of independently moving the gripping members  608   a ,  608   b . In the illustrated embodiment, the gripper control members  2202 ,  2204  are lines, such as sutures, wires, etc. that are removably attached to each of the gripper members  608   a ,  608   b , respectively, with both ends of the line extending through the delivery opening  716  of the delivery device  601 . The gripper control members  2202 ,  2204  can be independently pulled into and cast from the catheter to independently control the positions of the gripping members  608   a ,  608   b.    
     Referring to  FIGS. 22A-22D , another exemplary embodiment of valve repair system  600  is shown with another embodiment of a gripper control mechanism  611  used to control the gripping members  608   a - d  of another exemplary embodiment of a valve repair device  602 . For illustrative purposes, the paddles  606  of the valve repair device  602  are not shown on in  FIGS. 22A-22D , but it should be noted that the valve repair device  602  also includes paddles  606  that interact with the gripping members  608   a - d  to secure the valve repair device  602  to valve tissue, and the paddles  606  can take any suitable form, such as, for example, any form described in the present application.  FIG. 22A  illustrates the valve repair system  600  with the each of the four gripping members  608   a - d  in a first position, and  FIG. 22C  illustrates the valve repair system  600  with the one of the gripping members  608   a  moved to a second position.  FIG. 22B  is a top view (as indicated by the lines  22 B- 22 B shown in  FIG. 22A ) of the valve repair system  600  with each of the gripping members  608   a - d  being disposed in a first position.  FIG. 22D  is a cross-sectional view (as indicated by the lines C-C shown in  FIG. 22C ) of the valve repair system  600  with the gripping member  608   a  disposed the second position. Each of the four gripping members can be independently moved in the same manner as is illustrated by the gripping member  608   a.    
     The valve repair device  602  includes a first gripping member  608   a , a second gripping member  608   b , a third gripping member  608   c , and a fourth gripping member  608   d . Each of the gripping members  608   a - d  include a barbed portion  609   a - d  for securing the gripping members  608   a - d  to valve tissue. The gripper control mechanism  611  includes a first gripper control member  2202   a  configured to control the first gripping member  608   a , a second gripper control member  2202   b  configured to control the second gripping member  608   b , a third gripper control member  2202   c  configured to control the third gripping member  608   c , and a fourth gripper control member  2202   d  configured to control the fourth gripping member  608   d . In particular, the first gripper control member  2202   a  is configured to move the gripping member  608   a  in the direction X, and the second gripper control member  2202   b  is configured to move the second gripping member  608   b  in the direction X. In addition, the third gripper control member  2202   c  is configured to move the gripping member  608   c  in the direction Z, and the fourth gripper control member  2202   d  is configured to move the fourth gripping member  608   d  in the direction Z. Movement of the gripping members  608   a - b  in the direction X will adjust the width of the opening between the gripping members  608   a - b  and the corresponding paddle  606 , and movement of the gripping members  608   c - d  in the direction Z will adjust the width of the opening between the gripping members  608   c - d  and the corresponding paddle. The gripper control mechanism  611  is configured to move each of the gripping members  608   a - d  independently of each other. The gripper control members  2202   a - d  can take any suitable form that is capable of independently moving the gripping members  608   a - d . In the illustrated embodiment, the gripper control members  2202   a - d  are lines, such as sutures, wires, etc. that are removably attached to each of the gripper members  608   a - d , respectively, with both ends of the line extending through the delivery opening  716  of the delivery device  601 . The gripper control members  2202   a - d  can be independently pulled into and released from the catheter to independently control the positions of the gripping members  608   a - d.    
     Referring to  FIGS. 22A and 22B , each of the gripping members  608   a - d  are shown in an extended position. Referring to  FIGS. 22C and 22D , the first gripping member  608   a  is shown after the first gripper control member  2202   a  of the gripper control mechanism was pulled into the catheter causes the first gripping member  608   a  to move inward toward the shaft  603  in the direction X, and the other gripping members  608   b - d  remained in the position shown in  FIGS. 22A and 22B . In other words, the illustrated embodiment shown in  FIGS. 22A-22D  show a first gripping member  608   a  being independently controlled relative to the other gripping members  608   b - d . While the illustrated embodiment shows the first gripping member  608   a  being independently controlled, it should be understood that each of the gripping members  608   a - d  can be independently controlled by the corresponding gripper control member  2202   a - d  of the gripper control mechanism  611 . In addition, while the illustrated embodiment of  FIGS. 22A-22D  illustrate a valve repair assembly  600  having four gripping members  608   a - d  and four gripper control members  2202   a - d , it should be understood that any suitable number of gripping members and gripper control members can be utilized, and any number of the gripping members can be independently controlled by the gripper control mechanism. In addition, each of the gripping members  608   a - 608   d  can have any of the configurations disclosed in this application and each of the control mechanisms  2202   a - 2202   d  can have any of the forms disclosed in this application. 
     Referring to  FIG. 23 , another exemplary embodiment of a gripper control mechanism  611  includes a single line  2302 , such as a suture or wire, that is removably attached to the gripping members  608   a ,  608   b  and removably fixed between a placement shaft  613  and a  603  shaft of the valve repair device. The connection  615  between the placement shaft  613  and a  603  shaft of the valve repair device can be at a wide variety of different positions. In the illustrate example, the connection  615  is aligned or substantially aligned with ends of the gripping members  608   a ,  608   b . However, in other embodiments, the connection  615  can more distal, such as at a most proximal position that the coupler  605  can reach (see for example, the bailout positions of the coupler illustrated by  FIGS. 45C and 46D ). The single line  2302  is connected between the shaft  613  and the shaft  603 , such that the single line  2302  can independently control the gripping members  608   a ,  608   b . That is, movement of a first portion  2303  of the line  2302  in the direction Y will adjust the width W between the gripping member  608   a  and the paddle  606   a , but will not adjust the width H between the gripping member  608   b  and the paddle  606   b . Similarly, movement of a second portion  2305  of the line  2302  in the direction M will adjust the width H between the gripping member  608   b  and the paddle  606   b , but will not adjust the width W between the gripping member  608   a  and the paddle  606   a . After the valve repair device  602  is in the closed position and secured to valve tissue, the placement shaft  613  is detached from the shaft  603  of the valve repair device  602 . The detachment of the shaft  603  from the and the shaft  613  causes the line to be released. The line  2302  can then be retracted into the catheter to release the gripping members  608   a ,  608   b  by pulling one end of the line  2302  into the catheter. Pulling one end of the line into the catheter pulls the other end of the line through the gripping members  608   a ,  608   b  and then into the catheter. Any of the lines described herein can be retracted in this manner. 
     Referring to  FIG. 24 , in certain embodiments, the placement shaft  613  and the shaft  603  of the device  602  can be a hollow an fit over a coupling shaft  2400  that holds the shafts  613 ,  603  together. The shaft  603  of the device  602  can include a protruding portion  2406  and a recessed receiving portion  2408 . The positioning shaft  613  can include a protruding portion  2407  and a recessed receiving portion  2409 . When the shafts  613 ,  603  are coupled, the protruding portion  2406  of the shaft  603  is disposed in the receiving portion  2409  of the shaft  613 , and the protruding portion  2407  of the shaft  613  is disposed in the receiving portion  2408  of the shaft  603 . The shafts  613 ,  603  can be connected in a wide variety of different ways. For example, the shaft  613  can include a bore or channel  2411  that is aligned with a bore or channel  2413  of the shaft  602  when the protruding portions  2406 ,  2407  are disposed in the receiving portions  2408 ,  2409 , respectively. When the openings  2411 ,  2413  are aligned and the retaining shaft  2400  is placed into the openings  2411 ,  2413  in the direction X, the shafts  613 ,  603  are retained together. When the placement shaft is removed from the openings  2411 ,  2413  in the direction Z, protruding portions  2406 ,  2407  can be removed from the receiving portions  2408 ,  2409 , such that the device  602  is detached from the placement shaft  613 . 
     Still referring to  FIG. 24 , when the shafts  613 ,  603  are secured to each other, an aperture  2415  is created at interface  2417  between the shafts  613 ,  603 . The aperture  2415  is configured to secure the line  2302  between the shafts  613 ,  603  to allow for independent control of the gripping members  608   a ,  608   b . That is, the aperture  2415  is configured such that the line  2302  does not move relative to the aperture  2416  when the shafts  613 ,  603  are attached. Upon detachment of the shafts  613 ,  603 , the line  2302  is released from the aperture  2415  and can be removed from the valve repair device  602 . The line  2302  can then be retracted into the catheter to release the gripping members as described above. 
     Referring to  FIGS. 23 and 24A-24B , in an alternative embodiment, the line  2302  of the gripper control mechanism  610  is secured between the placement shaft  613  and the shaft  603  of by a threaded connection to independently control the gripper members  608   a ,  608   b . Referring to  FIG. 24A , the placement shaft  613  includes a male threaded member  2419 , and the shaft  603  includes a female threaded member  2421  configured to receive the male threaded member  2419  of the placement shaft  613 . However, the male and female threads can be reversed. The placement shaft  613  is secured to the shaft  603  by inserting the male threaded member  2419  into the female threaded member  2421  of the shaft  603 . The line  2302  of the gripper control mechanism  611  is disposed between the placement shaft  613  and the shaft  603  such that, when the placement shaft  613  is secured to the shaft  603 , the line  2302  is compressed (as shown by reference character M) between the placement shaft  613  and the shaft  603 . The compression M of the line  2302  between the placement shaft  613  and the shaft  603  causes the line  2302  to not move relative to the engagement point  2423  between the placement shaft  613 , the shaft  603 , and the line  2302  when the line  2302  is controlling the gripping members  608   a ,  608   b . As a result, the compression M and resulting retention of the line  2302  allows the line  2302  to independently control the gripping members  608   a ,  608   b.    
     Referring to  FIG. 25 , another exemplary embodiment of a gripper control mechanism  611  includes a first gripper control member  2502  and a second gripper control member  2504 . The first gripper control member  2502  is configured to move the gripping member  608   a  bi-directionally in the direction X, and the second gripper control member  2504  is configured to move the gripping member  608   b  bi-directionally in the direction Z. Movement of the gripping member  608   a  in the direction X will adjust the width W of the opening  614   a  between the gripping member  608   a  and the paddle  606   a , and movement of the gripping member  608   b  in the direction Z will adjust the width H of the opening between the gripping member  608   b  and the paddle  606   b . In the illustrated embodiment, the gripper control members  2202 ,  2204  include a push/pull link  2503 ,  2505 , such as, for example, a catheter, a flexible rod, or a stiff wire and a coupler  2506 ,  2507 . Each push/pull link  2503 ,  2505  extends from the delivery device  601  and is removably attached to the corresponding gripping member  608   a ,  608   b  by a coupler  2506 ,  2507 . The link  2503  is configured to be pushed and pulled in the direction Y. Movement of the link  2503  in the direction Y causes the gripping member  608   a  to move in the direction X. Similarly, the link  2505  is configured to be pushed and pulled in the direction M, and movement of the catheter  2505  in the direction M causes the catheter  2505  to move the gripping member  608   b  in the direction H. 
     In another embodiment of a the gripper control mechanism  611  is shown in  FIG. 25A . in this embodiment, the gripper control members  2202 ,  2204  include a suture  2511 ,  2513  and a flexible wire  2503 ,  2505 . In this embodiment, the first flexible wire  2503  includes a loop  2517  for receiving the first suture  2511  and for engaging a gripping member  608   a  ( FIG. 25 ), and the second flexible wire  2505  includes a loop  2519  for receiving the second suture  2513  and for engaging the gripping member  608   b  ( FIG. 25 ). The sutures  2517 ,  2519  are removably attached to each of the gripper members  608   a ,  608   b , respectively, with both ends of the line extending through the delivery device  601  as described above. Each of the wires  2503 ,  2505  extends from the delivery device  601  and the loops  2517 ,  2519  of the respective wires  2503 ,  2505  are able to move along the corresponding sutures  2511 ,  2513 , such that the loops  2517 ,  2519  can engage the corresponding gripping member  608   a ,  608   b  to move the gripping members (e.g., move the gripping members as described with respect to  FIG. 25 ). The wires  2503 ,  2505  can be made of, for example, steel, NiTi, or other wire or a plastic material. In certain embodiments, the wires  2503 ,  2505  can have a diameter of between about 0.1 mm and 0.35 mm, such as between about 0.15 mm and 0.3 mm, such as between about 0.2 mm and 0.25 mm. 
     Referring to  FIG. 26 , another exemplary embodiment of a gripper control mechanism  611  includes a first catheter  2603 , a second catheter  2605 , and single line  2604 , such as a wire or suture. The first catheter  2603  and line  2604  are configured to move the gripping member  608   a  in the direction X, and the second catheter  2605  and line  2604  configured to move the gripping member  608   b  in the direction Z. Movement of the gripping member  608   a  in the direction X will adjust the width W of the opening  614   a  between the gripping member  608   a  and the paddle  606   a , and movement of the gripping member  608   b  in the direction Z will adjust the width H of the opening between the gripping member  608   b  and the paddle  606   b . The line  2604  extends from the delivery device  601  through the catheters  2603 ,  2605  and is threaded through openings in both gripping member  608   a ,  608   b . Each catheter  2603 ,  2605  is configured to engage and move the corresponding gripping member  608   a ,  608   b . In particular, the catheter  2603  is configured to be pushed in the direction Y while the line  2604  is payed out of the catheter  2603  or tension in the line is reduced. The catheter  2603  is configured to be pulled in the direction Y while the line  2604  is pulled into the catheter  2603  or tension in the line is increased. Movement of the catheter  2603  in the direction Y causes the catheter  2603  to move the gripping member  608   a  in the direction X. Similarly, the catheter  2605  is configured to be pushed in the direction M while the line  2604  is payed out of the catheter  2605  or tension in the line is reduced. The catheter  2605  is configured to be pulled in the direction M while the line  2604  is pulled into the catheter  2605  or tension in the line is increased. Movement of the catheter  2505  in the direction M causes the catheter  2505  to move the gripping member  608   b  in the direction H. In an alternative embodiment, the gripper control mechanism  611  described above with reference to  FIG. 26  can include a first flexible wire with a loop (e.g., the flexible wire  2503  with the loop  2517  shown in  FIG. 25A ) and a second flexible wire with a loop (e.g., the flexible wire  2505  with the hoop  2519  shown in  FIG. 25A ), and the single line  2604  extends through the hoop  2517 ,  2519  of each of the wires  2503 . 
     Referring to  FIGS. 27A-29B , in certain embodiments, the valve repair device  602  and the paddle control mechanism  610  for a valve repair device  602  are configured such that each of the paddles  606  can be controlled independent of each other. Independent control for each of the paddles  606  is advantageous because the openings  614  between the paddles and the gripping members  608  can be adjusted independently as the valve repair device  602  is being attached to valve tissue (e.g., a mitral valve of a patient). In addition, independent paddle control will also be advantageous in situations in which one gripping member  608  and one paddle  606  sufficiently secure the valve repair device  602  to a first portion of valve tissue, but the other gripping member and the other paddle fail to connect the valve repair device to a second portion of valve tissue. In this situation, the paddle control mechanism  610  can be used to control only the paddle  606  that is not connected to the valve tissue to create an opening  614  for receiving the second portion of the valve tissue, and, after the second portion of the valve tissue is disposed in the opening, the unattached gripping member and the unattached paddle can be closed to secure the valve repair device  602  to the second portion of the valve tissue. 
     Referring to  FIGS. 27A-27C , the base assembly  604  of the valve repair device  602  includes a first shaft  603   a , a second shaft  603   b , a first coupler  605   a , and a second coupler  605   b . In addition, the paddle control mechanism  610  includes a first paddle control mechanism  2702  and a second paddle control mechanism  2704 . The first paddle control mechanism  2702  is configured to move the first coupler  605   a  along the shaft  603   a , and the second paddle control mechanism  2704  is configured to move the second coupler  605   b  along the shaft  603   b . Movement of the first coupler  605   a  along the shaft  603   a  causes the paddle  606   a  to move between an open position and a closed position, and movement of the second coupler  605   b  along the shaft  603   b  causes the paddle  606   b  to move between an open position and a closed position. In an alternative embodiment, the base assembly  604  can include a single shaft, a first coupler  605   a  attached to the single shaft, and a second coupler  605   b  attached to the single shaft. In this alternative embodiment, the paddle control mechanism  610  can include a first paddle control mechanism  2702  configured to move the first coupler  605   a  along the single shaft to cause the paddle  606   a  to move between an open position and a closed position, and a second paddle control mechanism  2704  configured to move the second coupler  605   b  along the single shaft to cause the paddle  606   b  to move between an open position and a closed position. 
       FIGS. 27A-27C  illustrate the paddles of the valve repair device moving between an open position and a closed position. The base assembly  604  of the valve repair device  602  includes a first link  2721  extending from point A to point B, a second link  2722  extending from point B to point C, a third link  2723  extending from point C to point D, a fourth link  2724  extending from point D to point E, and a fifth link  2725  extending from point E to point F. The coupler  605   a  is movably attached to the shaft  603   a , the coupler  605   b  is movably attached to the shaft  603   b , and the shafts  603   a ,  603   b  are fixed to the third link  2723 . The first link  2721  is pivotally attached to the coupler  605   a  at point A, such that movement of the coupler  605   a  along the shaft  603   a  moves the location of point A and, consequently, moves the first link  2721 . Similarly, the fifth link  2725  is pivotally attached to the coupler  605   b  at point F, such that movement of the coupler  605   b  along the shaft  603   b  moves the location of point F and, consequently moves the fifth link  2725 . The first link  2721  and the second link  2722  are pivotally attached to each other at point B, and the fifth link  2725  and the fourth link  2724  are pivotally attached to each other at point E. One paddle  606   a  is attached to the first link  2721  such that movement of the first link  2721  causes the paddle  606   a  to move, and the other paddle  606   b  is attached to the fifth link  2725  such that movement of the fifth link  2725  causes the paddle  606   b  to move. 
     Referring to  FIG. 27A , the paddles  606   a ,  606   b  are in the open position. Referring to  FIGS. 27A and 27B , the paddle  606   b  is moved from the open position (as shown in  FIG. 27A ) to the closed position (as shown in  FIG. 27B ) when the second paddle control mechanism  2704  moves the second coupler  605   b  along the shaft  603   b  in the direction Y, which causes a portion of the fifth link  2725  near point F to move in the direction H, and a portion of the fifth link  2725  near point E to move in the direction J. The paddle  606   b  is attached to the fifth link  2725  such that movement of the second coupler  605   b  in the direction Y causes the paddle  606   b  to move in the direction Z. In addition, the fourth link  2724  is pivotally attached to the fifth link  2725  at point E such that movement of the second coupler  605   b  in the direction Y causes the fourth link  2724  to move in the direction K. Referring to  FIG. 27B , the paddle  606   b  moves in the direction Q when moving from the open position to the closed position. In an alternative embodiment in which the pivotal connection at point E between the fourth link  2724  and the fifth link  2725  is significantly lower than pivotal connection at point F between the fifth link  2725  and the second coupler  605   b , movement of the paddle  606   b  from the open position to the closed position will act as shown in the embodiment shown in  FIG. 27A  except that the fourth link  2724  will initially move in the direction substantially opposite to the direction K as the paddle  606   b  is being closed. In any of the above-mentioned embodiments, the second paddle control mechanism  2704  can take any suitable form for moving the second coupler  605   b  along the shaft  603   b , such as, for example, any form of a paddle control mechanism described in the present application. 
     Referring to  FIGS. 27A and 27C , the paddle  606   a  is moved from the open position (as shown in  FIG. 27A ) to the closed position (as shown in  FIG. 27C ) when the first paddle control mechanism  2702  moves the first coupler  605   a  along the shaft  603   a  in the direction N, which causes a portion of the first link  2721  near point A to move in the direction L, and a portion of the first link  2721  near point B to move in the direction I. The paddle  606   a  is attached to the first link  2721  such that movement of the first coupler  605   a  in the direction N causes the paddle  606   a  to move in the direction V. In addition, the second link  2722  is pivotally attached to the first link  2721  at point B such that movement of the first coupler  605   a  in the direction N causes the second link  2722  to move in the direction R. Referring to  FIG. 27C , the paddle  606   a  moves in the direction T when moving from the open position to the closed position. In an alternative embodiment in which the pivotal connection at point B between the first link  2721  and the second link  2722  is significantly lower than pivotal connection at point A between the first link  2721  and the first coupler  605   a , movement of the paddle  606   a  from the open position to the closed position will act as shown in the embodiment shown in  FIG. 27A  except that the second link  2722  will initially move in the direction substantially opposite to the direction R as the paddle  606   b  is being closed. In any of the above-mentioned embodiments, the first paddle control mechanism  2702  can take any suitable form for moving the first coupler  605   a  along the shaft  603   a , such as, for example, any form of a paddle control mechanism described in the present application. 
     Referring to  FIGS. 28A-28C , in certain embodiments, the paddle control mechanism  610  includes a rack and pinion mechanism  2802  that is configured to selectively couple and decouple the paddles  606   a ,  606   b  from the shaft  603 . The rack and pinion mechanism  2802  includes a first member  2804  attached to the shaft  603  and a toothed member  2806   a ,  2806   b  attached to each of the paddles  606   a ,  606   b  and pivotally connected to a base member  2801  at connections points A, B. The first member  2804  is configured such that the paddles  606   a ,  606   b  can be moved between the open and closed positions independent of each other. In the illustrated embodiment, the first member  2804  has ribbed portion  2805  and an open portion  2807 . When the toothed member(s)  2806   a ,  2806   b  is aligned with the ribbed portion  2805  of the first member  2804 , the toothed member(s)  2806   a ,  2806   b  are configured to engage the ribbed portion  2805  such that movement of the shaft in the direction Y relative to the base member  2801  causes the toothed member  2806   a  to pivot about connection point A in the direction M to move the paddle  606   a  between an open position and a closed position in the direction H, and causes the toothed member  2806   b  to pivot about connection point B in the direction N to move the paddle  606   b  between an open position and a closed position in the direction Z. When the open portion  2807  of the first member  2804  is aligned with either of the toothed members  2806   a  or  2806   b , the tooth member that is aligned with the open portion  2807  is not engaged by the ribbed portion  2805  of the paddle  606   a  or  606   b . As a result, movement of the shaft  603  in the direction Y does not affect the position of the paddle  606   a  or  606   b.    
       FIGS. 28A-28B  illustrate the corkscrew mechanism  2802  in a first position. In the first position, the toothed members  2806   a ,  2806   b  for both paddles  606   a ,  606   b  are aligned with the ribbed portion  2805  of the first member  2804 . Referring to  FIG. 28A , when the shaft  603  is moved in the direction Y, the toothed members  2806   a ,  2806   b  both engage the ribbed portion  2805  of the first member, which causes both paddles  606   a ,  606   b  to be moved between the open and closed positions.  FIGS. 28C-28D  illustrate the corkscrew mechanism  2802  in a second position. In the second position, the toothed member  2806   a  is aligned with the open portion  2807  of the first member  2804 , and the toothed member  2806   b  is aligned with the ribbed portion  2806  of the first member  2804 . Referring to  FIG. 28C , when the shaft  603  is moved in the direction Y, the toothed member  2806   b  engages the ribbed portion  2805  of the first member  2804 , which causes the paddle  606   b  to be moved between the open and closed positions, and the toothed member  2806   a  does not engage the first member, which causes the paddle  606   a  to remain in a current position.  FIGS. 28E-28F  illustrate the corkscrew mechanism  2802  in a third position. In the third position, the toothed member  2806   b  is aligned with the open portion  2807  of the first member  2804 , and the toothed member  2806   a  is aligned with the ribbed portion  2806  of the first member  2804 . Referring to  FIG. 28E , when the shaft  603  is moved in the direction Y, the toothed member  2806   a  engages the ribbed portion  2805  of the first member  2804 , which causes the paddle  606   a  to be moved between the open and closed positions, and the toothed member  2806   b  does not engage the first member, which causes the paddle  606   b  to remain in a current position. In certain embodiments, the rack and pinion mechanism  2802  is moved between the positions shown in  FIGS. 28A-28F  by rotating the shaft  603 . In various embodiments, the rack and pinion mechanism  2802  includes a mechanism configured to maintain the paddles  606   a ,  606   b  in a desired position when the paddles are aligned with the open portion  2807  of the first member  2804 , but is also configured to allow the paddles to move when the paddles are aligned with the ribbed portion  2805  of the first member  2804 . The mechanism can take any suitable form, such as, for example, a clutch mechanism, a biasing member, a friction element, etc. 
     Referring to  FIGS. 29A-29B , the paddle control mechanism  610  is configured to move a coupler  605  along a shaft  603  to move the paddles  606   a ,  606   b  between the open and closed positions (similar to the embodiment shown in  FIGS. 6-12 ), and a locking mechanism  207  is configured to lock the coupler  605  on the shaft  603  to maintain the paddles  606   a ,  606   b  in a desired position. In certain embodiments, as shown in  FIGS. 29A-29B , each of the paddles  606   a ,  606   b  include a pin  2902   a ,  2902   b  and a slot  2904   a ,  2904   b . The pin  2902   a  is configured to move in slot  2904   a , and the pin  2902   b  is configured to move in slot  2904   b . The pins  2902   a ,  2902   b  are also configured to be locked in the slots  2904   a ,  2904   b . When a pin  2902   a ,  2902   b  is unlocked in a slot  2904   a ,  2904   b , the corresponding paddle  606   a ,  606   b  remains in a current position when the paddle control mechanism  610  moves the coupler  605  along the shaft  603 . When a pin  2902   a ,  2902   b  is locked in a slot  2904   a ,  2904   b , the corresponding paddle  606   a ,  606   b  moves between an open and closed position when the paddle control mechanism  610  moves the coupler  605  along the shaft  603 . 
       FIG. 29A  illustrates the valve repair device  602  with the paddles  606   a ,  606   b  in an open position.  FIG. 29B  illustrates the valve repair device  602  with the pin  2902   a  unlocked in slot  2904   a , and pin  2902   b  locked in slot  2904   b . Referring to  FIG. 29B , the lock  607  is in an unlocked condition such that the coupler  605  can be moved along the shaft  603 . Movement of the coupler  605  along the shaft  603  in the direction Y causes the paddle  606   b  to pivot about the locked pin  2902   b  such that the paddle  606   b  moves in the direction Z to a closed position. In addition, movement of the coupler  605  in the direction Y does not cause the paddle  606   a  to move because the pin  2902   a  is in an unlocked condition in the slot  2904   a . Instead, movement of the coupler  605  in the direction Y causes the pin  2902   a  to move in the slot  2904   a . Alternatively, the pin  2902   a  could be locked in slot  2904   a  and the pin  2902   b  could be unlocked in slot  2904   b , such that movement of the coupler  605  in the direction Y would cause the paddle  606   a  to move to a closed position, and the paddle  606   b  to remain in the open position (by the pin  2902   b  moving in the slot  2904   b ). In addition, the pin  2902   a  could be locked in slot  2904   a  and the pin  2902   b  could be locked in slot  2904   b , such that movement of the coupler  605  in the direction Y would cause both paddles  606   a ,  606   b  to move to the closed position. The pins  2902   a ,  2902   b  can be locked in the slot  2904   a ,  2904   b  by any suitable means, such as, for example, any means described herein with reference to lock  607 . 
     Referring to  FIG. 30 , in certain situations, the mitral valve  3001  of a patient can have a wide gap  3002  between the anterior leaflet  3003  and the posterior leaflet  3004  when the mitral valve is in a closed position (i.e., during the systolic phase). For example, the gap  3002  can have a width W between about 2.5 mm and about 17.5 mm, such as between about 5 mm and about 15 mm, such as between about 7.5 mm and about 12.5 mm, such as about 10 mm. In some situations, the gap  3002  can have a width W greater than 15 mm. In any of the above-mentioned situations, a valve repair device is desired that is capable of engaging the anterior leaflet  3003  and the posterior leaflet  3004  to close the gap  3002  and prevent regurgitation of blood through the mitral valve  3001 . 
       FIGS. 31A-37D  provide various embodiments of valve repair devices  602  that are configured to close a wide gap  3002  ( FIG. 30 ) between the anterior leaflet  3003  and posterior leaflet  3004  of a mitral valve  3001 . Referring to  FIGS. 31A-31B , an exemplary embodiment of a valve repair device  602  includes paddles  606  and gripping members  608 . In addition, the valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). Referring to  FIG. 31A , the paddles  606  of the valve repair device  602  are pivoted outward in the direction X to create an opening  614  between the paddles  606  and the gripping members  608  having a width W. The width W can be, for example, between about 5 mm and about 15 mm, such as between 7.5 mm and about 12.5 mm, such as about 10 mm. In alternative embodiments, the width W can be less than 5 mm or greater than 15 mm. Referring to  FIG. 31B , the paddles  606  of the valve repair device  602  are moved outward in the direction Z such that the opening  614  has a width H. The width H can be, for example, between about 10 mm and about 25 mm, such as between about 10 mm and about 20 mm, such as between about 12.5 mm and about 17.5 mm, such as about 15 mm. In alternative embodiments, the width H can be less than 10 mm or more than 25 mm. In certain embodiments, the ratio between the width H and the width W can be about 5 to 1 or less, such as about 4 to 1 or less such as about 3 to 1 or less, such as about 2 to 1 or less, such as about 1.5 to 1 or less, such as about 1.25 to 1 or less, such as about 1 to 1. The valve repair device  602  can be configured such that the paddles  606  are pivoted outward in the direction X and then moved outward in the direction Z to create the opening  614  having a width H between the paddles  606  and the gripping members  608 . Alternatively, the valve repair device  602  can be configured such that the paddles are moved outward in the direction Z and then pivoted outward in the direction X to create width H between the paddles  606  and gripping members  608 . In addition, the valve repair device  602  can be configured such that the paddles  606  are pivoted outward in the direction X and moved outward in the direction Z simultaneously to create the width H between the paddles  606  and the gripping members  608 . 
       FIGS. 32A-32C  illustrate a valve repair device  602  in which the paddles  606  are pivoted outward in the direction X, and, subsequently, moved outward in the direction Z to create a wider opening  614 .  FIG. 32A  illustrates the valve repair device  602  in a closed position, such that the paddles  606  are engaging the gripping members  608 . Referring to  FIG. 32B , the paddles  606  are pivoted outward in the direction X to create an opening  614  having a width W for receiving valve tissue. Referring to  FIG. 32C , after the paddles  606  are pivoted outward in the direction X, the paddles  606  are moved outward in the direction Z such that the opening  614  has a width H. After valve tissue is received in the openings  614  between the paddles  606  and the gripping members  608 , the valve repair device is moved back to the closed position (as shown in  FIG. 32A ) to secure the valve repair device  602  to the valve tissue. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
       FIGS. 33A-33C  illustrate a valve repair device  602  in which the paddles  606  are moved outward in the direction Z, and, subsequently, pivoted outward in the direction X to create a wider opening  614 .  FIG. 33A  illustrates the valve repair device  602  in a closed position, such that the paddles  606  are engaging the gripping members  608 . Referring to  FIG. 33B , the paddles  606  are moved outward in the direction Z to create an opening  614  having a width W for receiving valve tissue. Referring to  FIG. 33C , after the paddles  606  are moved outward in the direction Z, the paddles  606  are pivoted outward in the direction X such that the opening  614  has a width H. After valve tissue is received in the openings  614  between the paddles  606  and the gripping members  608 , the valve repair device is moved back to the closed position (as shown in  FIG. 33A ) to secure the valve repair device  602  to the valve tissue. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     While  FIGS. 32A-32C  illustrate a valve repair device  602  in which the paddles  606  are pivoted and then spread apart, and  FIGS. 33A-33C  illustrate a valve repair device  602  in which the paddles  606  are spread apart and then pivoted, it alternative embodiments, a valve repair device  602  can include paddles  606  that can be spread apart and pivoted simultaneously. In addition, in certain embodiments, the paddles  606  can be spread apart and pivoted independently of each other. That is, in the embodiments for the valve repair device  602  shown in  FIGS. 32A-32C and 33A-33C , as well as the embodiment in which the spreading apart and pivoting of each paddle  606  is completed simultaneously, the paddles  606  can be controlled independently of each other. 
     Referring to  FIGS. 34A-34B , another exemplary embodiment of a valve repair device  602  configured to close a wide gap  3002  ( FIG. 30 ) between the anterior leaflet  3003  and the posterior leaflet  3004  includes a W-shaped mechanism. In particular, the valve repair device  602  includes a coupler  605  configured to move along a shaft  603  and paddles  606  pivotally attached to the coupler  605 . The paddles  606  include an inner link  3402  and an outer link  3404 . The inner link  3402  of each paddle  606  is pivotally attached to coupler  605 , and the outer link  3404  of each paddle  606  is pivotally attached to the corresponding inner link  3402 . Referring to  FIG. 34A , the valve repair device  602  is shown in a closed position. Referring to  FIG. 34B , movement of the coupler  605  in the direction Y causes the inner links  3402  of the paddles  606  to extend in an outward direction X. In the illustrated example, the inner links  3402  engage a cam member  3403 , which forces the inner links  3402  to open in the X direction. Although the illustrated embodiment shows a valve repair device  602  having generally linear links  3402 ,  3404  that create a W-shaped mechanism, it should be understood that the links  3402 ,  3404  may take any suitable form that allows the valve repair device  602  to function as shown in  FIGS. 34A-34B . In embodiments in which the links  3402 ,  3404  take non-linear forms (e.g., a curved form), the valve repair device may not have a W-shaped mechanism, however, the valve repair device can include similar connections such that the valve repair device will function as shown in  FIGS. 34A-34B . 
     The outer links  3404  can be moved to the illustrated more open position in the direction Z in a variety of different ways. For example, the outer links cam be moved using any of the clasp control arrangements described herein. For example, movement of the outer links  3404  can be controlled using any of the clasp control arrangements shown in  FIGS. 22-26  and/or any of the paddle control arrangements described herein. In one embodiment, referring to  FIGS. 34C-34D , a link  3411  is attached to the pivotal connection between the inner link  3402  and the coupler  605  and the pivotal connection between the inner link  3402  and the outer link  3404 , such that movement of the coupler  605  in the direction Y causes a first end  3413  of the link  3411  to rotate in the direction M with the pivotal connection  3475 , which causes a second end  3415  of the link  3411  to rotate in the direction N with the pivotal connection  3477 . The rotation of the second end  3415  of the link  3411  in the direction N causes the outer link  3404  to move to an open position in the direction Z. 
     For illustrative purposes, the embodiment shown in  FIGS. 34C-34D  show a link  3411  for one of the paddles  606 , however, it should be understood that another link  3411  interacts with the other paddle in the same manner described above to cause the outer link  3404  of the other paddle to move to an open position in the direction Z. In an alternative embodiment, a four-bar linkage can be used to move the paddles  606  to an open position. In another alternative embodiment, a suture can be removably attached to the outer links  3404  of the paddles  606 , and the suture can be controlled to move the outer links  3404  of the paddles  606  to an open position in the direction Z. 
     In certain embodiments, the valve repair device  602  includes a biasing member  3410  (e.g., a spring) that attaches the inner links  3402  of the paddles  606  to each other. The biasing member  3410  maintains the inner links  3402  in a closed position (as shown in  FIGS. 34A and 34C ), until the inner links  3402  engage the cam member  3403  (as shown in  FIGS. 34B and 34D ). The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIGS. 35A-35B , another exemplary embodiment of a valve repair device  602  configured to close a wide gap  3002  ( FIG. 30 ) between the anterior leaflet  3003  and the posterior leaflet  3004  includes a W-shaped mechanism. In particular, the valve repair device  602  includes a coupler  605  configured to be moved along a shaft  603  and paddles  606  pivotally attached to the shaft and to the coupler  605 . The lower ends  3501  of each paddle  606  of the valve repair device  602  are pivotally connected to the shaft at point A. Each of the paddles  606  include an intermediate member  3502  that pivotally attach the paddles to the coupler  605  at pivot point B. Referring to  FIG. 35A , the valve repair device  602  is shown in a closed position. Referring to  FIG. 35B , movement of the coupler  605  in the direction Y causes the intermediate members  3502  of the paddles  606  to pivot such that a lower end  3503  of the intermediate members  3502  extend in an outward direction X, which causes the paddles  606  to move to an open position in the direction Z. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIGS. 36A-36B , another exemplary embodiment of a valve repair device  602  configured to close a wide gap  3002  ( FIG. 30 ) between the anterior leaflet  3003  and the posterior leaflet  3004  includes a W-shaped mechanism. In particular, the valve repair device  602  includes paddles  606  having a linkage  3602  pivotally attaching the paddles  606  to a shaft  603  of the valve repair device  602 . The linkage  3602  includes an inner link  3603  and an outer link  3605 . The inner link  3603  is pivotally attached to the shaft  603  and pivotally attached to the outer link  3605 . The outer link  3605  is pivotally attached to the inner link  3603  and pivotally attached to the paddle  606 . The paddles  606  are also attached to a link  3608  of the valve repair device  602 . A paddle control mechanism  610  is configured to move the pivotal connection at point A between the inner link  3603  and the outer link  3605  of the linkage  3602  in the direction Y, which causes the paddles  606  to move between an open position (as shown in  FIG. 36B ) and a closed position (as shown in  FIG. 36A ). 
     Still referring to  FIGS. 36A and 36B , although the paddle control mechanism is shown attached at the pivotal connection point A, it should be understood that the paddle control mechanism  610  can be attached to one or more of any of the links of the valve repair device  602 . For example, the paddle control mechanism  610  can be coupled to the paddle  606 , the link  3605 , and/or the link  3603 . The paddle control mechanism  610  can take any suitable form, such as, for example, a control wire or any other form described in the present application. For example, the paddle control device  610  can take the form of any of the gripper control devices shown in  FIGS. 6-8 and 22-26 . The valve repair device  602  can include any other features for a valve repair device discussed in the present application. 
     Referring to  FIG. 36C , the paddle control mechanism  610  of the embodiment illustrated by  FIGS. 36A and 36B  can include a spool  3620  and a line  3622  (e.g., a suture, a wire, etc.), and the line is attached to and wrapped around the spool. In this embodiment, creating a force on the line  3622  in the direction Z causes the spool  3620  to turn and line  3622  to be unwrapped from the spool. In this embodiment, the rotation of the spool  3620  causes the paddle control mechanism  610  to move in the direction Y and the valve repair device  602  to move to the open position (as shown in  FIG. 36B ). 
     Referring to  FIGS. 36D-36E , another exemplary embodiment of a valve repair device  602  configured to close a wide gap  3002  ( FIG. 30 ) between the anterior leaflet  3003  and the posterior leaflet  3004  includes a semi-rigid W-shaped mechanism. In particular, the valve repair device  602  has a linkage  3602  that flexibly attaches the paddles  606  to a shaft  603  of the valve repair device  602 . The linkage  3602  includes a rigid inner link  3603  and an outer rigid link  3605 . The inner rigid link  3603  is flexibly attached to the shaft  603  by a flexible member or portion  3613  and flexibly attached to the outer rigid link  3605  by a flexible member or portion  3611 , and the outer rigid link  3506  is flexibly attached to the paddle  606  by a flexible member or portion  3615 . The paddles  606  are also flexibly attached to a link  3608  of the valve repair device  602  by a flexible member or portion  3617 . The rigid links  3603 ,  3605  can be made of, for example, steel or nitinol. The flexible members  3611 ,  3613 ,  3615 ,  3617  can be made of, for example, nitinol. A paddle control mechanism  610  is configured to move the pivotal connection at point A between the inner link  3603  and the outer link  3605  of the linkage  3602  in the direction Y, which causes the paddles  606  to move between an open position (as shown in  FIG. 36D ) and a closed position (as shown in  FIG. 36C ). However, the paddle control mechanism  610  can be attached to one or more of any of the links of the valve repair device. For example, the paddle control mechanism  610  can be coupled to the paddle  606 , the link  3605 , and/or the link  3603 . The paddle control mechanism  610  can take any suitable form, such as, for example, a control wire or any other form described in the present application. For example, the paddle control device  610  can take the form of any of the gripper control devices shown in  FIGS. 6-8 and 22-26 . The valve repair device  602  can include any other features for a valve repair device discussed in the present application. 
     Referring to  FIGS. 37A-37D , another exemplary embodiment of a valve repair device  602  configured to close a wide gap  3002  ( FIG. 30 ) between the anterior leaflet  3003  and the posterior leaflet  3004  includes wire mesh paddles  606  and an internal cam  3702  configured to push the mesh paddles  606  apart. The internal cam  3702  is rotatably attached to the shaft  603  such that the cam can be moved between a first position (as shown in  FIGS. 37A-37B ) and a second position (as shown in  FIGS. 37C-37D ).  FIG. 37B  is a top view illustrating the internal cam  3702  in the first position, shown along the lines B-B in  FIG. 37A .  FIG. 37D  is a top view illustrating the internal cam  3702  in the second position, shown along the lines D-D in  FIG. 37C . 
     Referring to  FIGS. 37A and 37B , when the internal cam  3702  is in the first position, the internal cam does not engage the paddles  606 , and the valve repair device is maintained in a closed position. Referring to  FIGS. 37C and 37D , when the internal cam  3702  is in the second position, the internal cam engages the paddles  606  to move the paddles to move the paddles in an outward direction X to an open position. The valve repair device  602  is moved from the open position to the closed position by moving the internal cam  3702  from the second position to the first position. 
     In some embodiments, referring to  FIGS. 37E-37F , the paddles  606  of the valve repair device can include a flexible member or portion  3711  that bias the paddles into the closed position or the open position. The flexible member or portion  3711  can be configured to flex upon being engaged by the cam  3702  to allow the paddles  606  to move to the open position. The flexible member or portion  3711  is also configured to widen the reach of the paddles  606  when the paddles are in the open position. Any other suitable mechanisms can be used to bias the paddles in the closed position and/or widen the reach of the paddles  606  when the paddles are in the open position, such as, for example, a spring-loaded mechanism. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). The mesh paddles  606  can be made out of any suitable material that can be expanded by the internal cam  3702 , such as, for example, nitinol, stainless steel, or any braided or electrospun material. 
     Referring to  FIGS. 38-39 , in certain situations, the mitral valve  3001  of a patient can have a wide gap  3002  between the anterior leaflet  3003  and the posterior leaflet  3004  when the mitral valve is in a closed position (i.e., during the systolic phase). For example, the gap  3002  can have a width W between about 2.5 mm and about 17.5 mm, such as between about 5 mm and about 15 mm, such as between about 7.5 mm and about 12.5 mm, such as about 10 mm. In some situations, the gap  3002  can have a width W greater than 15 mm. In any of the above-mentioned situations, a valve repair device is desired that fills a sufficient volume to allow the gap  3002  to be closed or filled without placing a large amount of strain on the leaflets  3003 ,  3004 . For example, the valve repair device can include a spacer element  3800 . 
     Referring to  FIG. 39 , in certain embodiments, the spacer element  3800  is attached to the valve repair device  602 , such that, when the paddles  606  and gripping members  608  secure the valve repair device  602  to the mitral valve  3001 , the spacer element  3800  is disposed in the gap  3002  between the anterior leaflet  3003  and the posterior leaflet  3004 . The spacer element  3800  can be made of any suitable material, such as, for example, braided mesh, fabric, biocompatible material, foam, pericardial tissue, any material disclosed herein, etc. 
     Referring to  FIGS. 40A-40B , an exemplary embodiment of a valve repair device  602  has a spacer element  3800  attached to the shaft  603  of the valve repair device. The spacer element  3800  can extend past the outer edges  4001  of the gripping members  3800  as illustrated for providing additional surface area for closing the gap  3002  ( FIGS. 38-39 ) of a mitral valve  301 . In an alternative embodiment, the coupler member  605  can take the form of the spacer element  3800 . That is, a single element can be used as the coupler member  605  that causes the paddles  606  to move between the open and closed positions and the spacer element  3800  that closes the gap between the leaflets  3003 ,  3004  when the valve repair device  602  is attached to the leaflets. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIGS. 42A-42C , the spacer element  3800  shown in  FIGS. 40A-40B  can take a variety of different shapes. Referring to  FIG. 42A , an exemplary embodiment of a spacer element  3800  includes a main body  4210   a  extending between the gripping members  608  and past the edges  4201  of the gripping members, and extended portions  4212   a  that extend from the main body  4210   a . The extended portions  4212   a  allow portions of the gap  3002  ( FIGS. 38-39 ) of the mitral valve between the anterior leaflet  3003  and posterior leaflet  3004  and adjacent to the valve repair device  602  to be filled when the valve repair device is in a closed position. That is, when a valve repair device  602  is attached to a mitral valve to prevent regurgitation of blood through the mitral valve, the portions of the mitral valve next to the valve repair device may include openings from the tissue of the mitral valve extending around the valve repair device. The extended portions  4212   a  are configured to fill or plug the openings adjacent to the valve repair device  602 . In the illustrated embodiment, the length L of the extended portions  4212   a  are greater than the width W of the extended portions. 
     Referring to  FIG. 42B , another exemplary embodiment of a spacer element  3800  includes a main body  4210   b  extending between the gripping members  608  and extended portions  4212   b  that extend from the main body  4210   b . In the illustrated embodiment, the extended portions  4212   b  have a semicircular shape. The extended portions  4212   b  are configured to fill the openings adjacent to the valve repair device  602  due to tissue of the mitral valve extending around the valve repair device. 
     Referring to  FIG. 42C , another exemplary embodiment of a spacer element  3800  includes a main base assembly  4210   c  extending between the gripping members  608 , first extending portions  4212   c  that extend from the main body  4210   c , and second extending portions  4214   c  that extend from the first extending portions  4212   c . In the illustrated embodiment, the first extended portions  4212   c  have a semicircular shape, and the second extended portions  4214   c  have a length L that is greater than its width W. The extended portions  4212   b  are configured to fill the openings adjacent to the valve repair device  602  due to tissue of the mitral valve extending around the valve repair device. 
     Referring to  FIGS. 41A-41D , another exemplary embodiment of a valve repair device  602  has a spacer element  3800  attached to the gripping members  608   a ,  608   b  of the valve repair device. The spacer element  3800  includes a first portion  4102  attached to one gripping member  608   a  and a second portion  4104  attached to the other gripping member  608   b . Referring to  FIG. 41C , the valve repair device  602  is shown in the closed position. When the valve repair device  602  is in the closed position, the first portion  4102  of the spacer element  3800  and the second portion  4104  of the spacer element  3800  engage each other and surround the shaft  603  (as shown in  FIG. 41B ). Referring to  FIG. 41D , the valve repair device  602  is shown in the open position, the first portion  4102  of the spacer element  3800  moves with the gripping member  608   a , and the second portion  4104  of the spacer element  3800  moves with the gripping member  608   b . A spacer element  3800  having multiple portions  4102 ,  4104  allows the gripping members  608   a ,  608   b  to be moved to adjust the width of the opening between the paddles  606  and the gripping members, which is advantageous in attaching the valve repair device  602  to valve tissue  820 . Referring to  FIG. 41B , the spacer element  3800  extends past the outer edges  4001  of the gripping members  3800  for providing additional surface area for filling the gap  3002  ( FIGS. 38-39 ) of a mitral valve  301 . The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIGS. 43A-43C , the spacer element  3800  shown in  FIGS. 41A-41D  can take a variety of different shapes. Referring to  FIG. 43A , an exemplary embodiment of a spacer element  3800  in the closed position includes a main body  4310   a  extending between the gripping members  608  and past the edges  4201  of the gripping members, and extended portions  4312   a  that extend from the main body  4310   a . The extended portions  4312   a  allow portions of the gap  3002  ( FIGS. 38-39 ) of the mitral valve between the anterior leaflet  3003  and posterior leaflet  3004  and adjacent to the valve repair device  602  to be filled when the valve repair device is in a closed position. That is, when a valve repair device  602  is attached to a mitral valve to prevent regurgitation of blood through the mitral valve, the portions of the mitral valve next to the valve repair device may include openings from the tissue of the mitral valve extending around the valve repair device. The extended portions  4312   a  are configured to fill the openings adjacent to the valve repair device  602 . In the illustrated embodiment, the length L of the extended portions  4312   a  are greater than the width W of the extended portions. 
     Referring to  FIG. 43B , another exemplary embodiment of a spacer element  3800  in the closed position includes a main body  4310   b  extending between the gripping members  608  and extended portions  4312   b  that extend from the main body  4310   b . In the illustrated embodiment, the extended portions  4312   b  have a semicircular shape. The extended portions  4312   b  are configured to fill the openings adjacent to the valve repair device  602  due to tissue of the mitral valve extending around the valve repair device. 
     Referring to  FIG. 43C , another exemplary embodiment of a spacer element  3800  includes a main base assembly  4310   c  extending between the gripping members  608 , first extending portions  4312   c  that extend from the main body  4310   c , and second extending portions  4314   c  that extend from the first extending portions  4312   c . In the illustrated embodiment, the first extended portions  4312   c  have a semicircular shape, and the second extended portions  4314   c  have a length L that is greater than its width W. The extended portions  4312   b  are configured to fill the openings adjacent to the valve repair device  602  due to tissue of the mitral valve extending around the valve repair device. 
     Referring to  FIGS. 44A-44B , in certain embodiments, an expanding spacer element  3800  is integral with the valve repair device  602 . The expanding spacer element  3800  is configured to expand as the paddles  606  close (as shown in  FIG. 44B ). Referring to  FIG. 44A , the valve repair device  602  is in an open position such that valve tissue can be received in the opening  614  between the expanding spacer element  3800  and the paddles  606 . Referring to  FIG. 44B , the valve repair device  602  is in the closed position, in which the paddles  606  and the expanded spacer element  3800  are engaged to secure the valve repair device to valve tissue. When the spacer elements  3800  and the paddles  606  are engaged, the spacer element  3800  expands to provide a larger surface area for closing a gap  3002  ( FIG. 38 ) between the anterior leaflet  3003  and posterior leaflet  3004  of a mitral valve  3001 . In the illustrated embodiment, the valve repair device  602  takes the form of the valve repair device  602  in  FIGS. 35A-35B . However, any valve repair device  602  described in the present application can include an expanding spacer element  3800 . The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIGS. 45A-46D , in certain situations, the valve repair device  602  needs to be detached from a native valve and removed from the patient. In these situations, it is advantageous to have a valve repair device that can be narrowed and rearranged (to a bailout position) such that the valve repair device will be easier to remove from the patient without disturbing any valve tissue of the patient&#39;s heart. Referring to  FIGS. 45A-45C , the base assembly  604  of an exemplary embodiment of a valve repair device  602  includes a first link  4521  extending from point A to point B, a second link  4522  extending from point A to point C, a third link  4523  extending from point B to point D, a fourth link  4524  extending from point C to point E, and a fifth link  4525  extending from point D to point E. A coupler  605  is movably attached to a shaft  603 , and the shaft  603  is fixed to the fifth link  4525 . The first link  4521  and the second link  4522  are pivotally attached to the coupler  605  at point A, such that movement of the coupler  605  along the shaft  603  moves the location of point A and, consequently, moves the first link  4521  and the second link  4522 . The first link  4521  and the third link  4523  are pivotally attached to each other at point B, and the second link  4522  and the fourth link  4524  are pivotally attached to each other at point C. One paddle  606   a  is attached to first link  4521  such that movement of first link  4521  causes the paddle  606   a  to move, and the other paddle  606   b  is attached to the second link  4522  such that movement of the second link  4522  causes the paddle  606   b  to move. 
     In order to move the valve repair device  602  from the closed position (as shown in  FIG. 45A ) to the bailout position (as shown in  FIG. 45C ), the coupler  605  is moved along the shaft  603  in the direction Y, which moves the pivot point A for the first link  4521  and the second link  4522  to a new position. Referring to  FIG. 45A , the valve repair device  602  is shown in a closed position with an angle α between the paddle  606  and the shaft  603 . The angle α can be, for example, between about 0 degrees and about 45 degrees, such as between about 5 degrees and about 40 degrees, such as between about 15 degrees and about 30 degrees, such as between about 20 degrees and about 25 degrees. Referring to  FIG. 45B , the valve repair device  602  is moved to the open position by moving the coupler  605  along the shaft  603  in the direction Y. Movement of the coupler  605  in the direction Y causes the first link  4521  to pivot about point A such that the first link  4521  and the second link  4522  move outward in the direction Z, which causes the paddles  606   a ,  606   b  to move downward and outward in the direction H. Referring to  FIG. 45C , the valve repair device  602  is moved to the bailout position by continuing to move the coupler  605  along the shaft  603  in the direction Y. The continued movement of the coupler  605  in the direction Y causes the first link  4521  and the second link  4522  to move inward in the direction M, which causes the paddles  606   a ,  606   b  to move downward and inward in the direction N. Still referring to  FIG. 45C , in the bailout position, the valve repair device  602  has an angle θ between the paddles  606  and the shaft  603 . The angle θ can be, for example, greater than or equal to 120 degrees, such as greater than or equal to 130 degrees, such as greater than or equal to 140 degrees, such as greater than or equal to 150 degrees, such as greater than or equal to 160 degrees. 
     Referring to  FIGS. 46A-46D , the base assembly  604  of another exemplary embodiment of a valve repair device  602  includes a first link  4621  extending from point A to point B, a second link  4622  extending from point A to point C, a third link  4623  extending from point B to point D, a fourth link  4624  extending from point C to point E, a fifth link  4625  extending from point D to point F, and a sixth link  4626  extending from point E to point F. A coupler  605  is movably attached to a shaft  603 , and the shaft  603  is attached to the fifth link  4625  and the sixth link  4626  at point F. The first link  4621  and the second link  4622  are pivotally attached to the coupler  605  at point A, such that movement of the coupler  605  along the shaft  603  moves the location of point A and, consequently, moves the first link  4621  and the second link  4622 . The fifth link  4625  and the sixth link  4626  are pivotally attached to the shaft at point F, such that movement of the shaft moves the location of point F and, consequently, moves the fifth link  4625  and the sixth link  4626 . A locking element  4631  is configured to selectively lock the fifth link  4625  and the sixth link  4626  to the shaft at point F, such that the fifth link  4625  and the sixth link  4626  cannot pivot relative to the shaft  603  when the locking element  4631  is in the locked position. However, when the locking element  4631  is in the unlocked position, the fifth link  4625  and the sixth link  4626  can pivot about the shaft  603  when the shaft moves the location of point F (as described above). The first link  4621  and the third link  4623  are pivotally attached to each other at point B, and the second link  4622  and the fourth link  4624  are pivotally attached to each other at point C. One paddle  606   a  is attached to first link  4621  such that movement of first link  4621  causes the paddle  606   a  to move, and the other paddle  606   b  is attached to the second link  4622  such that movement of the second link  4622  causes the paddle  606   b  to move. 
     In order to move the valve repair device  602  from the closed position (as shown in  FIG. 46A ) to a bailout position (as shown in  FIG. 46C ), the locking element  4631  is maintained in a locked position, and the coupler  605  is moved along the shaft  603  in the direction Y, which moves the pivot point A for the first link  4621  and the second link  4622  to a new position. In order to move the valve repair device  602  from the bailout position to the collapsed bailout position (as shown in  FIG. 46D ), the locking element  4631  is moved to an unlocked position, and the shaft  603  is moved in the direction D, which moves the pivot point F for the fifth link  4625  and the sixth link  4626  to a new position, which causes the fifth link  4625  and the sixth link  4626  to pivot about the shaft  603 . 
     Referring to  FIG. 46A , the valve repair device  602  is shown in a closed position with an angle α between the paddle  606  and the shaft  603 . The angle α can be, for example, between about 0 degrees and about 45 degrees, such as between about 5 degrees and about 40 degrees, such as between about 15 degrees and about 30 degrees, such as between about 20 degrees and about 25 degrees. Referring to  FIG. 46B , the valve repair device  602  is moved to the open position by moving the coupler  605  along the shaft  603  in the direction Y. Movement of the coupler  605  in the direction Y causes the first link  4621  and the second link  4622  to move outward in the direction Z, which causes the paddles  606   a ,  606   b  to move downward and outward in the direction H. The locking element  4631  is maintained in the locked position when the valve repair device  602  is moved from the closed position (as shown in  FIG. 46A ) to the open position (as shown in  FIG. 46B ). 
     Referring to  FIG. 46C , the valve repair device  602  is moved to the bailout position by continuing to move the coupler  605  along the shaft  603  in the direction Y. The continued movement of the coupler  605  in the direction Y causes the first link  4621  and the second link  4622  to move inward in the direction M, which causes the paddles  606   a ,  606   b  to move downward and inward in the direction N. Still referring to  FIG. 45C , in the bailout position, the valve repair device  602  has an angle θ between the paddles  606  and the shaft  603 . The angle θ can be, for example, greater than or equal to 120 degrees, such as greater than or equal to 130 degrees, such as greater than or equal to 140 degrees, such as greater than or equal to 150 degrees, such as greater than or equal to 160 degrees. The locking element  4631  is maintained in the locked position when the valve repair device  602  is moved from the open position (as shown in  FIG. 46B ) to the bailout position (as shown in  FIG. 46C ). 
     Referring to  FIG. 46D , the valve repair device  602  is moved from the bailout position to the collapsed position by moving the locking element  4631  to an unlocked position and moving the shaft  603  in the direction D, which causes the fifth link  4625  and the sixth link  4626  to pivot about connection point F and move upward in a direction J, which causes the third link  4623  and the fourth link  4624  to move inward and downward in the direction Q, which causes the paddles  606   a ,  606   b  to move downward and inward in the direction Q. Still referring to  FIG. 46D , in the collapsed bailout position, the valve repair device  602  has an angle μ between the paddles  606  and the shaft  603 . The angle μ can be, for example, greater than or equal to 120 degrees, such as greater than or equal to 130 degrees, such as greater than or equal to 140 degrees, such as greater than or equal to 150 degrees, such as greater than or equal to 160 degrees, such as greater than or equal to 170 degrees. 
     It is advantageous to have a valve repair device that includes features to ensure that the valve repair device remains in a closed position after the valve repair device is attached to the native valve of a patient. In other words, it is advantageous to have a valve repair device that includes features to prevent the valve repair device from becoming detached from the native valve of a patient after placement of the valve repair device inside of the patient, which could cause problems (e.g., regurgitation of blood through the mitral valve). Examples of additional features for preventing a valve repair device from becoming detached from a native valve are shown in  FIGS. 47A-49 . 
     Referring to  FIGS. 47A-47B , an exemplary embodiment of a valve repair device  602  includes a latch member  4701  attached to the paddles  606 , in which the latch member  4701  is configured to attach the paddles  606  to the gripping members  608  when the valve repair device is in the closed position. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). In the illustrated embodiment, the valve repair device  602  includes an optional lock  607  configured to keep a coupler  605  in a locked condition on the shaft  603 . If the optional lock  607  fails, however, the coupler  605  could move on the shaft  603  and cause the valve repair device to move to an open position. The latch member  4701  is configured to keep the valve repair device  602  in the closed position if the lock  607  fails. 
     Referring to  FIG. 47A , the valve repair device  602  is in an open position with valve tissue  820  disposed in the opening  614  between the paddles  606  and the gripping members  608 . Referring to  FIG. 47B , the valve repair device  602  is moved to the closed position such that the valve tissue  820  is secured between the paddles  606  and the gripping members  608  of the valve repair device. The valve repair device  602  can be moved to the closed position by any suitable manner, such as, for example, any manner described in the present application. When the valve repair device  602  is moved to the closed position, the latch member  4701  punctures the valve tissue  820  and the gripping member  608  to secure the paddle to the gripping member. The latch member  4701  can take any suitable form that is capable of securing the paddles  606  to the gripping members  608 , such as, for example, metals, plastics, etc. 
     Referring to  FIG. 48 , another exemplary embodiment of a valve repair system  600  includes a delivery device  601  and a valve repair device  602 , in which is delivery device is configured to deliver the valve repair device to the native valve of a patient, and in which the valve repair device is configured to attach to leaflets of a native valve to repair the native valve of the patient. The delivery device  601  can take any suitable form that is capable of delivering the valve repair device  602  to the native valve of a patient, such as, for example, any form described in the present application. The valve repair device  602  includes a base assembly  604 , a pair of paddles  606 , and a pair of gripping members  608 . The base assembly  604  of the valve repair device  602  has a shaft  603  and a coupler  605  configured to move along the shaft. The coupler  605  is mechanically connected to the paddles such that movement of the coupler along the shaft  603  causes the paddles to move between an open position and a closed position. In the closed position, the paddles  606  and the gripping members  608  engage valve tissue and each other to secure the valve repair device  602  to the valve tissue. The valve repair device  602  also includes a biasing member  4807  (e.g., a spring) configured to bias the coupler  605  on the shaft such that the valve repair device  602  is in a closed position. 
     In certain embodiments, the valve repair system  600  includes a placement shaft  613  that is removably attached to the shaft  603  of the base assembly  604  of the valve repair device  602 . After the valve repair device  602  is secured to valve tissue, the placement shaft  613  is removed from the shaft  603  to remove the valve repair device  602  from the valve repair system  600 , such that the valve repair device  602  can remain attached to the valve tissue, and the delivery device  601  can be removed from a patient&#39;s body. After the valve repair device  602  is attached to the valve tissue, and the valve repair system  600  is removed from the patient&#39;s body, the biasing member  4807  maintains the valve repair device in a closed position to prevent detachment of the valve repair device from the valve tissue. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIG. 49 , another exemplary embodiment of a valve repair system  600  includes a delivery device  601  and a valve repair device  602 , in which the delivery device is configured to deliver the valve repair device to the native valve of a patient, and in which the valve repair device is configured to attach to leaflets of a native valve to repair the native valve of the patient. The delivery device  601  can take any suitable form that is capable of delivering the valve repair device  602  to the native valve of a patient, such as, for example, any form described in the present application. The valve repair device  602  includes a base assembly  604 , a pair of paddles  606 , and a pair of gripping members  608 . The base assembly  604  of the valve repair device  602  has a shaft  603  and a coupler  605  configured to move along the shaft. In the illustrated embodiment, the shaft  603  includes a threaded portion  4902 , and the coupler  605  is configured to move along the threaded portion  4902  of the shaft. That is, rotating the shaft  603  causes the coupler  605  to move up and down the shaft  603 . The coupler  605  is mechanically connected to the paddles such that movement of the coupler along the shaft  603  causes the paddles to move between an open position and a closed position. In the closed position, the paddles  606  and the gripping members  608  engage valve tissue and each other to secure the valve repair device  602  to the valve tissue. 
     In certain embodiments, the valve repair system  600  includes a placement shaft  613  that is removably attached to the shaft  603  of the base assembly  604  of the valve repair device  602 . After the valve repair device  602  is secured to valve tissue, the placement shaft  613  is removed from the shaft  603  to remove the valve repair device  602  from the valve repair system  600 , such that the valve repair device  602  can remain attached to the valve tissue, and the delivery device  601  can be removed from a patient&#39;s body. After the valve repair device  602  is attached to the valve tissue, and the valve repair system  600  is removed from the patient&#39;s body, the valve repair device is prevented from detaching from the valve tissue, because the coupler can only be moved by rotating the shaft  603 . The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIGS. 50-54 , embodiments of valve repair systems  600  include a delivery device  601  and a valve repair device  602 , in which the delivery device is configured to deliver the valve repair device to the native valve of a patient, and in which the valve repair device is configured to attach to leaflets of a native valve to repair the native valve of the patient. The delivery device  601  can take any suitable form that is capable of delivering the valve repair device  602  to the native valve of a patient, such as, for example, any form described in the present application. The valve repair device  602  is similar to the valve repair devices described above and includes a base assembly  604 , a pair of paddles  606 , and a pair of gripping members  608 . The base assembly  604  of the valve repair device  602  has a shaft  603  and a coupler  605  configured to move along the shaft. The coupler  605  is mechanically connected to the paddles such that movement of the coupler along the shaft  603  causes the paddles to move between an open position and a closed position. In some embodiments, the valve repair device  602  includes a lock  607  configured to lock the coupler  605  in a desired position on the shaft (as shown in  FIGS. 50-53B ). In alternative embodiments, the valve repair device  602  includes a biasing member  4807  configured to maintain the coupler  605  in a desired position on the shaft  603  (as shown in  FIG. 54 ). In the closed position, the paddles  606  and the gripping members  608  engage valve tissue and each other to secure the valve repair device  602  to the valve tissue. In certain embodiments, the valve repair system  600  includes a placement shaft  613  that is removably attached to the shaft  603  of the base assembly  604  of the valve repair device  602 . After the valve repair device  602  is secured to valve tissue, the placement shaft  613  is removed from the shaft  603  to remove the valve repair device  602  from the valve repair system  600 , such that the valve repair device  602  can remain attached to the valve tissue, and the delivery device  601  can be removed from a patient&#39;s body. The valve repair device  602  can include any other features for a valve repair device discussed in the present application, and the valve repair device  602  can be positioned to engage valve tissue  820  as part of any suitable valve repair system (e.g., any valve repair system disclosed in the present application). 
     Referring to  FIG. 50 , in some embodiments, the gripping members  608  are attached to the paddles  606 . In the example illustrated by  FIG. 50 , the gripping members  608  include an attachment portion  5010 , a hinge or flex portion  5012 , and a gripping or barbed portion  5014 . The attachment portion  5010  can take any form that allows the gripping member to be attached to the paddle  606 . The hinge or flex portion  5012  can take a variety of different forms. For example, the hinge or flex portion can be configured to bias the gripping or barbed portion  5014  toward the attachment portion  5010 . In one exemplary embodiment, the hinge or flex portion  5012  biases the gripping or barbed portion  5014  to a fully closed position where the gripping or barbed portion engages the attachment portion  5010  and/or the paddle  606 . When valve tissue is positioned between the paddle  606  and the gripping portion  5014 , the hinge or flex portion biases the gripping portion  5014  to clamp the valve tissue between the gripping or barbed portion  5014  and the paddle. The gripping member  608  illustrated by  FIG. 50  moves with the paddle  606 . The hinge or flex portion  5012  allows the gripping portion  5014  to move in the direction indicated by arrows  5020  and can allow the gripping portion to be pulled in the direction indicated by arrows  5022 . 
     In certain embodiments, it is advantageous for the barbed portion  609  to be disposed toward a proximal end of the gripping members  608  because it will provide for an easier release of the gripping members  608  from valve tissue. Referring to  FIG. 51 , in one embodiment, the gripping members  608  comprise a single row of barbs  5102  configured to engage the valve tissue and the paddles  606  to secure the valve repair device to the valve tissue. The single row of barbs  5102  makes it easier for the gripping portion  5014  to release from the valve tissue. In an alternative embodiment, the gripping members  608  can comprise two or more rows of barbs  5102  disposed at a proximal end of the gripping members  608 . In additional embodiments, the barbs  5102  can be disposed at a proximal end of the gripping members  608  in any other suitable configuration that provides for an easier release of the gripping members  608  from valve tissue. 
     In some embodiments, as shown in  FIGS. 51A-51E , the gripping member  608  is configured to place a tensioning force on the valve tissue when the valve repair device (e.g., any valve repair device  602  described in the present application) is attached to the valve tissue. The gripping member  608  is slidably connected to the paddle  606 , such that the gripping member  608  can be moved along the paddle in the direction X. For example, a gripper control mechanism  611  can be used to move the gripping member  608  along the paddle  606  in the direction X, and the gripper control mechanism  611  can also be used to move the gripping member  608  between the closed position (as shown in  FIG. 51A ) and the open position (as shown in  FIG. 51B ). The gripper control mechanism  611  can take any form described in the present application. In certain embodiments, the valve repair device  602  includes an optional biasing member  5122  (e.g., a spring) configured to maintain the gripping member  608  in a desired position along the paddle  606  (e.g., the position shown in  FIGS. 51A and 51E ). In the illustrated embodiment, the gripping member  608  includes a single row of barbs  609  at a proximal end of the gripping members (e.g. as shown in the embodiment of the valve repair device  602  shown in  FIG. 51 ), however, it should be understood that the features described herein regarding  FIGS. 51A-51E  can be used with any of the embodiments of the valve repair device described in the present application. 
     Referring to  FIG. 51A , the gripping member  608  is shown in a first position on the paddle  606  and in a closed position. Referring to  FIG. 51B , the gripping member  608  is shown after it has been moved in the direction Z to an open position by the gripper control mechanism  611 . Referring to  FIG. 51C , the gripping member  608  is shown after it has been moved along the paddle  606  in the direction D to a second position. In certain embodiments, the gripping member  608  is moved along the paddle in the direction D by the gripper control mechanism  611  or a separate mechanism. In embodiments that include the biasing member  5122 , enough force needs to be applied on the gripping member  608  to move the gripping member in the direction D, which will cause the biasing member to expand and create a tensioning force on the gripping member  608  in the direction B. While the illustrated embodiment shows the gripping member  608  being moved to an open position (as shown in  FIG. 51B ) prior to the gripping member  608  being moved along the paddle  606  in the direction D to the second position (as shown in  FIG. 51C ), it should be understood that gripping member  608  can be moved in the direction D to the second position prior to the gripping member  608  being moved in the direction Z to an open position or the movements can be simultaneous. Referring to  FIG. 51D , the gripping member  608  is moved to a closed position in the direction Y by the gripper control mechanism  611  to secure the barbed portion  609  of the gripping member  608  to valve tissue (not shown). In the position shown in  FIG. 51D , the biasing member  5122  is being maintained in an extended position (e.g., as a result of the force applied to the gripping member  608  by the gripper control mechanism (or another mechanism) to keep the gripping member in the second position), which means the biasing member  5122  is placing a tensioning force on the gripping member  608  in the direction B. Referring to  FIG. 51E , after the barbed portion  609  of the gripping member  608  is secured to the valve tissue, the force maintaining the gripping member  608  in the second position is released, which causes the tensioning force applied by the biasing member  5122  to move the gripping member  608  along the paddle  606  in the direction M. The movement of the gripping member  608  in the direction M causes the barbed portion  609  to create a tensioning force on the valve tissue in the direction T. This tensioning force on the valve tissue allows the valve repair device  602  to maintain a secure connection to the valve tissue. 
     In another embodiment, as shown in  FIGS. 51F-51G , the gripping member  608  includes a barbed portion  609  and a weakened or flexing portion  5103 . The barbed portion  609  is disposed on a first side  5111  of the weakened or flexing portion  5103 . In the illustrated embodiment, the barbed portion  609  includes a single row of barbs, but it should be understood that any suitable configuration of the barbs can be used, such as, for example, any configuration described in the present application. The weakened portion or flexing  5103  can be, for example, a cutout in the gripping member, a different material as compared to the remainder of the gripping member  608 , or can take any other suitable form that allows the weakened or flexing portion  5103  to be weaker and/or more flexible than a remained of the gripping member  608 . However, in other embodiments, the weaker and flexible portion  5103  is omitted and the link  5107  and line  5105  described below are still able to flex the barbed portion as illustrated by  FIGS. 51F-51H . 
     Referring to  FIGS. 51F-51H , the gripper control mechanism  611  includes a line  5105  (e.g., a suture) and a push/pull link  5107  configured to receive the line  5105 . For example, the push/pull link  5107  can be a catheter, a wire with a loop (as shown  FIG. 25A ), or any other link that is capable of receiving the line  5105  and pushing/pulling the gripping member  608 . A first end  5125  of the line  5105  extends from a delivery device (e.g., any delivery device  601  described in the present application) and is removably attached to the gripping member  608  on a first side  5111  of the weakened or flexible portion  5103  at a first connection point A. The line  5105  also extends from the connection point A and is removably attached to the gripping member  608  on a second side  5113  of the weakened or flexible portion  5103  at a second connection point B. In addition, the line  5105  extends from the second connection point B and through push/pull link  5107 . 
     Referring to  FIG. 51F , the gripping member  608  is shown in an open position with a valve tissue member  820  disposed in an opening  614  between the gripping member  608  and a paddle (not shown). The gripping member can be moved to the open position by pulling on the line  5105 . Referring to  FIG. 51G , the link  5107  and line  5105  of the gripper control mechanism  611  is used to move the gripping member  608  in the direction X to the closed position and flex the portion  609  in the direction Y. The first end  5125  of the line  5105  is pulled in a direction Y, such that the first side  5111  of the gripping member  608  pivots or flexes about the weakened portion  5103 . This flexing causes the barbed portion  609  to move in directions U and Y to a flexed position. Still referring to  FIG. 51G , the link  5107  and the line  5105  are moved such that the barbed portion  609  pierces the valve tissue  820  while the barbed portion is in the flexed position. 
     Referring to  FIG. 51H , the line  5105  is released, which causes the first end  5111  of the gripping member  608  to pivot about the weakened or flexible portion  5103 . This causes the barbed portion  609  to move through the valve tissue  820  in a direction D, which causes the barbed portion  609  the valve repair device to create a tensioning force on the valve tissue  820  in the direction D. After the gripping member  608  is secured to the valve tissue  820  (as shown in  FIG. 51H ), the link  5107  and the line  5105  are removed from the gripping member  608 . 
     Referring to  FIG. 52 , in various embodiments, the gripping members  608  include a stretchable portion  5202  to allow for movement in the direction  5204 . The movement in the direction  5204  allows for clean disengagement from the valve tissue. In some embodiments, the stretchable portion  5202  is configured to be moved such that the barbs  5102  exit the valve tissue in a direction substantially opposite the direction in which the barbs entered the valve tissue. Alternatively, the gripping members  608  can be otherwise extendable to allow for disengagement from the valve tissue without tearing the valve tissue. For example, as mentioned above, the hinge portions  5012  can be configured to allow the gripping portions  5014  of the gripping members  608  to be pulled in the direction  5204 . 
     Referring to  FIGS. 53A-53B , in certain embodiments, the gripping members  608  are made of flexible material. Referring to  FIG. 53A , the valve repair device  602  is shown in a closed position and secured to valve tissue  820 . Referring to  FIG. 53B , the gripping members  608  are shown being moved by the gripper control mechanism  611  to remove the gripping members  608  from the valve tissue  820 . In particular, movement of the gripper control mechanism  611  in the direction Y causes the gripping members  608  to peel back off of the valve tissue in the direction Z. The flexible material of the gripping members  608  allows for the peeling back of the gripping members  608  when removing the gripping members from the valve tissue  820 . The peeling back of the gripping members  608  is advantageous because it helps the gripping members to pull out of the valve tissue  820  without damaging the valve tissue. In certain embodiments, the flexible gripping members  608  allows for the barbed portion  609  of the gripping members  608  to be removed from valve tissue in a direction substantially opposite the direction in which the barbs entered the valve tissue. 
     Referring to  FIG. 54 , in certain embodiments, the gripping members  608  are connected to each other by a separate biasing member  5410  (e.g., a spring) that is configured to maintain the gripping members in a desired position, such that, when the paddles  606  are in an open position, a width W exists between the paddles and the gripping members. The width W can be adjusted by engaging the gripping members  608  with the gripper control mechanism  611 . That is, movement of the gripper control mechanism  611  into the delivery device in the direction Z will cause the biasing member  5410  to flex and the paddles to move in an inward direction X. Disengagement of the gripping members by the gripper control mechanism  611  will cause the biasing member  5410  to move the desired position (as shown in  FIG. 54 ). The gripper control mechanism  611  can take any suitable form for controlling the gripping members  608 , such as, for example, any form described in the present application. In addition, when the paddles  606  are moved to the closed position, the paddles will engage the gripping members  608 , which will cause the biasing member to flex and the gripping members to move in an inward direction X. The paddles  608  can be moved from the open position to the closed position in any suitable manner, such as, for example, any manner described in the present application. While the various devices described in the present application refer to engaging and repairing the mitral valve, it should be understood that these devices can be used in repairing any other native valves (e.g., the tricuspid valve, the pulmonary valve, the aortic valve) or any other portion of the heart. In addition, it should be understood that various features of the various embodiments for the devices described herein can be used in combination with each other. 
     While the foregoing is a complete description of the preferred embodiments of the invention, various alternatives, modifications, and equivalents can be used. Moreover, it will be obvious that certain other modifications can be practiced within the scope of the appended claims.