Fenestration devices, systems, and methods for aortic arch repair

An aortic repair system for treating an aortic arch of a patient, the aortic repair system comprising:

• a base member, comprising—
• a main body having a first end portion and a second end portion, wherein the main body defines a fluid conduit, and wherein the first end portion defines a first fluid opening;
• a septum extending through the main body from the second end portion of the main body toward the first end portion of the main body, wherein the septum divides the fluid conduit into a primary lumen having a first cross-sectional area and a secondary lumen having a second cross-sectional area less than the first cross-sectional area, and wherein the second end portion of the main body defines a second fluid opening for the primary lumen;
• and
• a leg extending from the second end portion of the main body, wherein the leg defines a leg lumen fluidly coupled to the secondary lumen, and wherein the leg has an end portion defining a third fluid opening for the secondary lumen;
• a spanning member configured to be coupled to the second end portion of the main body, the spanning member defining a spanning member lumen configured to be fluidly coupled to the primary lumen via the second fluid opening, wherein the spanning member includes a fenestration region sized and shaped to align with at least one branching vessel from the aortic arch, and wherein the fenestration region is configured to be pierced to form a fenestration in the spanning member to perfuse the at least one branching vessel, wherein the spanning member comprises:
• a first spanning member comprising a stent structure including a plurality of struts, the plurality of struts comprising a first plurality of struts extending fully around a perimeter of the spanning member, and a second plurality of struts extending around only a portion of the perimeter of the first spanning member to define a stent-free section along the perimeter of the spanning member, and wherein the stent-free section at least partially defines the fenestration region;
• or
• a second spanning member comprising a stent structure and material coupled to the stent structure to define the spanning member lumen, wherein the material includes a first material having a first fenestration resistance and a second material having a second fenestration resistance less than the first fenestration resistance, and wherein the second material at least partially defines the fenestration region;
• or
• a third spanning member comprising a stent structure and graft material coupled to the stent structure to define the spanning member lumen, the graft material comprising a first portion and a second portion radially aligned with the first portion, wherein at least one of the first portion and the second portion are configured to deflect radially inwardly into the spanning member lumen.