Medical device delivery system and deployment method

An aortic stent-graft comprising:

• a tubular graft extending from a proximal fluid inflow end to a distal fluid outflow end, the graft comprising a proximal edge, a proximal sealing portion and an intermediate portion distal of the proximal sealing portion, wherein a proximal end of the intermediate portion abuts a distal end of the proximal sealing portion;
• at least one discrete sealing stent attached to the proximal sealing portion, wherein the at least one discrete sealing stent has a proximal end adjacent the proximal edge of the tubular graft, and a distal end that terminates proximal of the intermediate portion;
• a first fenestration window disposed in the intermediate portion, the first fenestration window having a length determined by the equation L1=1.23*D−23 millimeters, where L1 is the length of the first fenestration window and D is between about 30 millimeters and about 46 millimeters,
• a second fenestration window, wherein a proximal end of the second fenestration window abuts a distal end of the first fenestration window,
• a first fenestration and a second fenestration formed in the first fenestration window, wherein the first and second fenestrations are longitudinally spaced from each other, and
• a third fenestration formed in the second fenestration window, wherein the third fenestration is longitudinally spaced from the first and second fenestrations,
• wherein each of the first, second and third fenestrations has a closed perimeter which is positioned entirely distal of the proximal inflow end of the tubular graft and
• wherein the first and second fenestrations are separated by a longitudinal distance greater than a longitudinal distance between the second and third fenestrations,
• wherein the at least one discrete sealing stent is disposed proximally of each of the first, second and third fenestrations,
• wherein a proximal end of the first fenestration window abuts the distal end of the proximal sealing portion, the proximal sealing portion having a length of less than or equal to 55 millimeters, and
• wherein the second fenestration window extends distally toward the distal end of the tubular graft, wherein the second fenestration window has a length determined by the equation L2=0.3*D+7 millimeters, where L2 is the length of the second fenestration window and D is between about 30 millimeters and about 46 millimeters.