Aortic root implants and related systems and methods

A method of treating a dissection comprising:

• advancing a first guide wire into a descending aorta into an ascending aorta;
• advancing a prosthetic implant delivery system through the descending aorta and into the ascending aorta over the first guide wire, the prosthetic implant delivery system comprising an outer sheath and a proximal sheath extending through the outer sheath, the outer sheath carrying an expandable root support structure;
• retracting the outer sheath toward the descending aorta to expose the proximal sheath over the first guide wire;
• advancing the proximal sheath out of the ascending aorta to expose a proximal portion of the expandable root support structure, wherein the proximal portion comprises an aortic valve;
• further retracting the outer sheath toward the descending aorta to expose at least a portion of a distal portion of the expandable support structure,
• advancing a first expandable branch of the expandable support structure into a coronary artery over a first coronary access wire, wherein the first expandable branch comprises a telescoping structure comprising a proximal portion, a middle portion, and a distal portion, and wherein the first expandable branch is configured to pivot the expandable branch between 0 degrees and 360 degrees, relative to a first axis, and
• retracting the outer sheath into the descending aorta to fully expose distal portion of the expandable root support structure within the ascending aorta.

A graft delivery system, the system comprising:

• a guide wire lumen;
• a distal capsule comprising a plurality of bearing elements;
• a distal locking ring and a proximal locking ring;
• and
• a prosthetic implant system comprising an expandable root support structure,
• wherein a proximal end of the expandable root support structure is connected to the proximal locking ring,
• wherein a distal end of the expandable root support structure is connected to the distal locking ring, and
• wherein the plurality of bearing elements, the distal locking ring, and the proximal locking ring are configured to rotate about a guide wire lumen.