An apposition device having a first elongate element movably coupled with a second elongate element. The second elongate element is deployable distal to the structures to be apposed, in a position transverse to the first elongate element. The first elongate element may be pulled to pull the second elongate element to move the structures into apposition. A third element may be positioned proximal to the structures to hold the structures in apposition. The third element may be a ratcheting element fixable in place with respect to the first elongate element. The apposition device may be deployed with a fine gauge needle. The second elongate element may be deployed from a side port in the needle facilitating deployment, and/or movement of the second elongate element with respect to the first elongate element and into a deployment configuration. Such arrangement may allow control of the first elongate element independent of the needle.