Tissue engagement devices can include a sheath, a first arm, a second arm and an actuation cannula. At least a proximal portion of each arm is within the sheath. The actuation cannula is also within the sheath, and can move within the sheath between a retracted position and an extended position. The actuation cannula moves at least a portion of each of the first and second arms into a region between an exterior surface of the actuation cannula and an interior surface of the sheath as the actuation cannula moves to the extended position.
