Devices and methods are provided for tissue approximation and repair. Fixation devices comprise a pair of elements each having a first end, a free end opposite the first end, and an engagement surface therebetween for engaging the tissue, the first ends being moveable between an open position wherein the free ends are spaced apart and a closed position wherein the free ends are closer together with the engagement surfaces generally facing each other. The fixation devices include a locking mechanism coupled to the elements for locking the elements in place. The devices and methods find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions. The invention is particularly useful in procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site.