Devices, systems, and methods for delivering and deploying an implantable medical device with respect to a target site along a tissue wall by applying suction to draw the tissue wall to a delivery and deployment device, such as to a tissue-penetrating end of the delivery and deployment device. An additional implantable device may be deployed distal to the tissue wall, such as to facilitate manipulation of the distal wall. At least a portion of the first implantable medical device may be deployed with respect to the additional implantable medical device, such as within a lumen of the additional implantable medical device. The implantable medical device may shift from a delivery configuration to an expanded deployed configuration, and at least a portion of the implantable medical device may expand beyond the deployed configuration after deployment device to further resist migration of the implantable medical device from the target site.