A method is provided, comprising: (1) making a transapical puncture into a left ventricle of the heart; (2) making a transseptal fenestration in the heart; (3) delivering a prosthetic valve via the transapical puncture and implanting the prosthetic valve at a mitral valve of the heart; and (4) subsequently to delivering the prosthetic valve and making the transseptal fenestration, closing the transapical puncture. Other embodiments are also described.