Devices and methods for managing access through tissue is disclosed. The device includes a body. The body is movable from a pre-deployed configuration towards a deployed configuration. The device includes a plurality of tissue engaging portions that extend from the body. At least a portion of the tissue engaging portions are obtuse. At least two of the tissue engaging portions are separated by a first distance in the deployed configuration and a second distance in the pre-deployed configuration. The first distance is smaller than the second distance. The method includes deploying a closure element to tissue adjacent a tissue opening to substantially close the opening following a first procedure. The method also includes selectively opening the opening in the tissue by advancing a distal end of a medical device through the deployed closure element as a part of or before a second procedure.