An apparatus, comprising: a support member configured to be transitioned between a first configuration and a second configuration, when the support member is in the first configuration a contact portion of the support member is configured to be inserted through an organ wall from a first side of the organ wall to a second side of the organ wall, when the support member is in the second configuration the contact portion of the support member is configured to contact the second side of the organ wall to limit movement of the organ wall, the contact portion of the support member having a first size when the support member is in the first configuration and a second size when the support member is in the second configuration, the second size larger than the first size, the support member having a guide portion including a surface along which a puncture member can be slidably disposed, the puncture member configured to puncture the organ wall when the puncture member is moved along the surface and when the support member is in the second configuration; and the puncture member , configured to be slidably coupled to the guide portion of the support member, the puncture member further configured to be transitioned from a first puncture configuration to a second puncture configuration, when the puncture member is in the first puncture configuration the puncture member has a first diameter and is arranged to puncture the first side of the organ wall to produce an opening, when the puncture member is in the second puncture configuration the puncture member has a second diameter smaller than the first diameter, and a diameter of the opening in the organ wall. a support member configured to be transitioned between a first configuration and a second configuration, when the support member is in the first configuration a contact portion of the support member is configured to be inserted through an organ wall from a first side of the organ wall to a second side of the organ wall, when the support member is in the second configuration the contact portion of the support member is configured to contact the second side of the organ wall to limit movement of the organ wall, the contact portion of the support member having a first size when the support member is in the first configuration and a second size when the support member is in the second configuration, the second size larger than the first size, the support member having a guide portion including a surface along which a puncture member can be slidably disposed, the puncture member configured to puncture the organ wall when the puncture member is moved along the surface and when the support member is in the second configuration; and the puncture member , configured to be slidably coupled to the guide portion of the support member, the puncture member further configured to be transitioned from a first puncture configuration to a second puncture configuration, when the puncture member is in the first puncture configuration the puncture member has a first diameter and is arranged to puncture the first side of the organ wall to produce an opening, when the puncture member is in the second puncture configuration the puncture member has a second diameter smaller than the first diameter, and a diameter of the opening in the organ wall. <EOS>