A medical assembly implanting an atrial sealing skirt in the heart at an atrial sealing skirt deployment site and related methods of implantation and delivery. An anchor is endovascularly introduced into the heart and implanted to a cardiac wall with an anchor delivery system and delivery cable. A second delivery system introduces a tether which coupled to the implanted anchor and an atrial sealing skirt. The atrial sealing skirt includes a top brim which is positioned to conform to the atrial floor at the deployment site. The sealing skirt may be integrated with a valve or serve as a receptacle.