Methods and systems for providing or maintaining fluid flow through body passages

A method of diverting fluid flow from a first passage to a second passage to effect retroperfusion in the second passage, the method comprising:

• forming a fistula between the first passage and a second passage;
• deploying a stent graft, wherein, after deploying the stent graft, a first portion of the stent graft is in the first passage, a second portion of the stent graft is in the second passage, and a third portion of the stent graft is in the fistula;
• and
• making a valve in the second passage incompetent to reduce inhibition of retroperfusion through the second passage by the valve, wherein making the valve in the second passage incompetent comprises advancing a reverse valvulotome in a direction opposite native fluid flow in the second passage, wherein, during advancing the reverse valvulotome, a blade of the reverse valvulotome disables the valve.

A method of diverting fluid flow from a first passage to a second passage to effect retroperfusion in the second passage, the method comprising:

• forming a fistula between the first passage and a second passage, wherein forming the fistula between the first passage and the second passage comprises dilating the fistula;
• and
• making a valve in the second passage incompetent to reduce inhibition of retroperfusion through the second passage by the valve, wherein making the valve in the second passage incompetent comprises deploying a stent across the valve,
• advancing a reverse valvulotome in a direction opposite native fluid flow in the second passage, wherein, during advancing the reverse valvulotome, a blade of the reverse valvulotome disables the valve.