A suture attachment catheter (100; 302; 402) 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 operably attached to the distal end of the catheter body, the suture attachment assembly including: a rail (110; 310; 410) defining a portion of a clamping jaw; a distal clamping jaw (106; 306; 406) hingedly operably attached to the rail; and a proximal clamping jaw (108; 308; 408) operably attached to the rail, wherein the rail enables at least one of the proximal clamping jaw and the distal clamping jaw to be selectively slideable with respect to the other of the proximal clamping jaw and the distal clamping jaw to adjust a distance between the proximal clamping jaw and the distal clamping jaw of the clamping jaw; a needle (154; 322; 454) selectively slideable within the catheter body, the needle configured to penetrate a valve leaflet to insert a suture through the valve leaflet when the valve leaflet is captured between the proximal clamping jaw and the distal clamping jaw; and a control handle operably attached to the proximal end of the catheter body, the control handle including: a steering mechanism operably connected to the catheter body to selectively steer the distal end of the catheter body; a jaw actuator operably connected to the clamping jaw; and a needle actuator operably connected to the needle. a generally flexible catheter body having a proximal end, a distal end, and a length greater than 100 cm; a suture attachment assembly operably attached to the distal end of the catheter body, the suture attachment assembly including: a rail (110; 310; 410) defining a portion of a clamping jaw; a distal clamping jaw (106; 306; 406) hingedly operably attached to the rail; and a proximal clamping jaw (108; 308; 408) operably attached to the rail, wherein the rail enables at least one of the proximal clamping jaw and the distal clamping jaw to be selectively slideable with respect to the other of the proximal clamping jaw and the distal clamping jaw to adjust a distance between the proximal clamping jaw and the distal clamping jaw of the clamping jaw; a rail (110; 310; 410) defining a portion of a clamping jaw; a distal clamping jaw (106; 306; 406) hingedly operably attached to the rail; and a proximal clamping jaw (108; 308; 408) operably attached to the rail, wherein the rail enables at least one of the proximal clamping jaw and the distal clamping jaw to be selectively slideable with respect to the other of the proximal clamping jaw and the distal clamping jaw to adjust a distance between the proximal clamping jaw and the distal clamping jaw of the clamping jaw; a needle (154; 322; 454) selectively slideable within the catheter body, the needle configured to penetrate a valve leaflet to insert a suture through the valve leaflet when the valve leaflet is captured between the proximal clamping jaw and the distal clamping jaw; and a control handle operably attached to the proximal end of the catheter body, the control handle including: a steering mechanism operably connected to the catheter body to selectively steer the distal end of the catheter body; a jaw actuator operably connected to the clamping jaw; and a needle actuator operably connected to the needle. a steering mechanism operably connected to the catheter body to selectively steer the distal end of the catheter body; a jaw actuator operably connected to the clamping jaw; and a needle actuator operably connected to the needle.