A tissue engagement device (130, 300) comprising: a sheath; a cannular base (104, 304); a first arm (108a, 308a) that extends from the cannular base (104, 304), at least a proximal portion of the first arm (108a, 108b) being within the sheath, the distal end of the first arm (108a, 308a) comprising a first tissue engaging member with a distal tip, said distal tip having a first piercing surface; a second arm (108b, 308b) that extends from the cannular base (104, 304), at least a proximal portion of the second arm (108b, 308b) being within the sheath, the distal end of the second arm comprising a second tissue engaging member with a distal tip, said distal tip having a second piercing surface; and an actuation cannula (145, 345) within the sheath, the actuation cannula (145, 345) being configured to move within the sheath between a retracted position and an extended position, wherein the first arm (108a, 308a) and the second arm (108b, 308b) cover a distal end of the actuation cannula (145, 345) when the actuation cannula (145, 345) is in the retracted position, characterized in that distal movement of the actuation cannula (145, 345) to the extended position moves at least a portion of each of the first and second arms (108a, 308a, 108b, 308b) into a region between an exterior surface of the actuation cannula (145, 345) and an interior surface of the sheath and uncovers the distal end of the actuation cannula (145, 345), wherein the first and second engaging members extend laterally outward at an angle relative to the respective first and second arms (108a, 308a, 108b, 308b) such that each of the first piercing surface and the second piercing surface is configured to embed within a layer of tissue and move in a direction transverse to the surface of the target tissue layer as the actuation cannula (145, 345) moves distally to the extended position to put a region of the layer of tissue under tension between the first arm (108a, 308a) and the second arm (108b, 308b). a sheath; a cannular base (104, 304); a first arm (108a, 308a) that extends from the cannular base (104, 304), at least a proximal portion of the first arm (108a, 108b) being within the sheath, the distal end of the first arm (108a, 308a) comprising a first tissue engaging member with a distal tip, said distal tip having a first piercing surface; a second arm (108b, 308b) that extends from the cannular base (104, 304), at least a proximal portion of the second arm (108b, 308b) being within the sheath, the distal end of the second arm comprising a second tissue engaging member with a distal tip, said distal tip having a second piercing surface; and an actuation cannula (145, 345) within the sheath, the actuation cannula (145, 345) being configured to move within the sheath between a retracted position and an extended position, wherein the first arm (108a, 308a) and the second arm (108b, 308b) cover a distal end of the actuation cannula (145, 345) when the actuation cannula (145, 345) is in the retracted position, characterized in that distal movement of the actuation cannula (145, 345) to the extended position moves at least a portion of each of the first and second arms (108a, 308a, 108b, 308b) into a region between an exterior surface of the actuation cannula (145, 345) and an interior surface of the sheath and uncovers the distal end of the actuation cannula (145, 345), wherein the first and second engaging members extend laterally outward at an angle relative to the respective first and second arms (108a, 308a, 108b, 308b) such that each of the first piercing surface and the second piercing surface is configured to embed within a layer of tissue and move in a direction transverse to the surface of the target tissue layer as the actuation cannula (145, 345) moves distally to the extended position to put a region of the layer of tissue under tension between the first arm (108a, 308a) and the second arm (108b, 308b).