A suture attachment catheter (102; 302; 402; 502) configured to repair a heart valve by inserting a suture in a valve leaflet of a beating heart of a patient, comprising: a generally flexible catheter body having a proximal end, a distal end and a length greater than 100 cm; a suture attachment assembly proximate the distal end of the catheter body, the suture attachment assembly including: a proximal clamping jaw (108; 308; 408; 508) disposed adjacent the distal end of the catheter body; a rail (110; 310; 410; 510) having a proximal portion and distal portion, the proximal portion configured to be selectively longitudinally slideable with respect to the proximal clamping jaw (108; 308; 408; 508); a distal clamping jaw (106; 306; 406; 506) hingedly attached to the distal portion of the rail (110; 310; 410; 510); a control handle (150; 600) operable attached to the proximal end of the catheter body, the control handle (150; 600) including: a rail actuator configured to selectively longitudinally slide the rail (110; 310; 410; 510) with respect to the proximal clamping jaw (108; 308; 408; 508); and a jaw actuator configured to selectively pivot the distal clamping jaw (106; 306; 406; 506) between a first position for delivery of the suture attachment assembly into the heart and a second position for capturing a valve leaflet between the proximal clamping jaw (108; 308; 408; 508) and the distal clamping jaw (106; 306; 406; 506); and a flexible member extending from the jaw actuator through the catheter body to a distal surface of the distal clamping jaw (106; 306; 406; 506), wherein the jaw actuator selectively moves the flexible member to pivot the distal clamping jaw (106; 306; 406; 506). a generally flexible catheter body having a proximal end, a distal end and a length greater than 100 cm; a suture attachment assembly proximate the distal end of the catheter body, the suture attachment assembly including: a proximal clamping jaw (108; 308; 408; 508) disposed adjacent the distal end of the catheter body; a rail (110; 310; 410; 510) having a proximal portion and distal portion, the proximal portion configured to be selectively longitudinally slideable with respect to the proximal clamping jaw (108; 308; 408; 508); a distal clamping jaw (106; 306; 406; 506) hingedly attached to the distal portion of the rail (110; 310; 410; 510); a proximal clamping jaw (108; 308; 408; 508) disposed adjacent the distal end of the catheter body; a rail (110; 310; 410; 510) having a proximal portion and distal portion, the proximal portion configured to be selectively longitudinally slideable with respect to the proximal clamping jaw (108; 308; 408; 508); a distal clamping jaw (106; 306; 406; 506) hingedly attached to the distal portion of the rail (110; 310; 410; 510); a control handle (150; 600) operable attached to the proximal end of the catheter body, the control handle (150; 600) including: a rail actuator configured to selectively longitudinally slide the rail (110; 310; 410; 510) with respect to the proximal clamping jaw (108; 308; 408; 508); and a jaw actuator configured to selectively pivot the distal clamping jaw (106; 306; 406; 506) between a first position for delivery of the suture attachment assembly into the heart and a second position for capturing a valve leaflet between the proximal clamping jaw (108; 308; 408; 508) and the distal clamping jaw (106; 306; 406; 506); and a rail actuator configured to selectively longitudinally slide the rail (110; 310; 410; 510) with respect to the proximal clamping jaw (108; 308; 408; 508); and a jaw actuator configured to selectively pivot the distal clamping jaw (106; 306; 406; 506) between a first position for delivery of the suture attachment assembly into the heart and a second position for capturing a valve leaflet between the proximal clamping jaw (108; 308; 408; 508) and the distal clamping jaw (106; 306; 406; 506); and a flexible member extending from the jaw actuator through the catheter body to a distal surface of the distal clamping jaw (106; 306; 406; 506), wherein the jaw actuator selectively moves the flexible member to pivot the distal clamping jaw (106; 306; 406; 506).