Abstract: A body tissue has oppositely disposed first and second tissue sides with an aperture extending therebetween. An apparatus for selectively permitting access through the body tissue includes a proximal balloon adapted for placement adjacent the first tissue side. A distal balloon is adapted for placement adjacent the second tissue side. An expandable support member is adapted to extend through the aperture and defines a support member lumen providing fluid communication between the first and second tissue sides. The expandable support member is attached to the proximal and distal balloons and has at least one of an inner support member lining and an outer support member cover. A support member valve is located within the support member lumen and selectively permits access through the aperture between the first and second tissue sides. A closure device is provided for permanently occluding the support member lumen.