The present disclosure includes devices and techniques for threading one or more catheters to the apex or base of the right
ventricle by transfemoral
vein access to the right
ventricle. The
catheter can be passed through to turn upward, directed towards the
mitral valve, by
puncturing the ventricular septum into the left
ventricle through the ventricular side or right side of the heart. From this
entry point in the left ventricle, flail
mitral valve leaflets can be sutured and tethered, pulled back into place, and re-attached with grounding anchors in the right ventricle, or embedded in the
septal wall. The ventricular septal crossing technique may include passing a coaxial conduit through a first access conduit, where the first access conduit may act as a guide to direct an inner or second coaxial conduit toward a flail
mitral valve leaflet.