The invention provides devices and methods for suture placement while performing less invasive surgical procedures within a body cavity. In an exemplary embodiment, the invention provides for the placement of sutures within the heart or a great vessel that is accessed from outside the closed chest. According to one exemplary method, the patient's heart valve is accessed through an intercostal port in the patient's chest. At least one needle having a suture is then directed into the annulus while visualizing through the port placement of the needle into the annulus. The needle is then passed through the annulus.