Abstract: Devices, systems and methods are disclosed for the mapping of electrical signals and the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be transformed from a compact, linear configuration to a helical configuration, such as to map and ablate pulmonary vein ostia.

Abstract: A steerable catheter system is provided including an elongated shaft having a proximal end, a distal end and an outer surface. The outer surface includes at least one cavity configured to facilitate movement of the distal end relative to the proximal end so as to steer the elongated shaft. A catheter tip is attached to the distal end of the shaft. The catheter tip comprises a curved body having at least one RF cutting edge and at least one non-cutting area recessed from the at least one cutting edge.

Abstract: Methods and apparatus are provided for monopolar neuromodulation, e.g., via a pulsed electric field. Such monopolar neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, monopolar neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such monopolar neuromodulation is performed bilaterally.

Abstract: A system for providing current to perform a surgical procedure includes an electrosurgical device having a conductive cutting wire and a power source with a power cord providing current to the cutting wire from a power source. The power cord and device are connected via a magnetic connection. The magnetic connection includes a device housing coupled to a cord housing, where a magnetic post is received in a recess for mechanically and electrically connecting the cutting wire and an active wire of the power cord. The recess and the magnetic post can be coaxial, with the axes being perpendicular to longitudinal axes of the device housing and the cord housing so that the connection can withstand a force exerted along the longitudinal axis, but a sufficient force transverse to the longitudinal axes and along the axes of the recess and the post can de-couple the magnetic connection.

Abstract: Devices and methods for cooling microwave antennas are disclosed herein. The cooling systems can be used with various types of microwave antennas. One variation generally comprises a handle portion with an elongate outer jacket extending from the handle portion. A microwave antenna is positioned within the handle and outer jacket such that cooling fluid pumped into the handle comes into contact directly along a portion of the length, or a majority of the length, or the entire length of the antenna to allow for direct convective cooling. Other variations include cooling sheaths which form defined cooling channels around a portion of the antenna. Yet another variation includes passively-cooled systems which utilize expandable balloons to urge tissue away from the surface of the microwave antenna as well as cooling sheaths which are cooled through endothermic chemical reactions. Furthermore, the microwave antennas themselves can have cooling lumens integrated directly therethrough.

Abstract: A catheter and a console for a catheter. In one embodiment, the catheter includes: (1) a wall having a substantially annular cross-section and surrounding a bore, (2) a plurality of optical fibers associated with the wall and terminating at a distal end of the wall in end faces of differing, non-perpendicular orientation with respect to longitudinal axes of the plurality of optical fibers and (3) photoacoustic layers coupled to at least some of the end faces and configured to generate an ultrasonic signal in response to laser light transmitted along the plurality of optical fibers.

Abstract: Devices, systems, and methods for providing commanded movement of an end effector of a manipulator while providing a desired movement of one or more joints of the manipulator. Methods include calculating weighted joint velocities using a weighting matrix within the joint space to anisotropically emphasize joint movement within a null-space to provide the desired movement of a first set of joints. Methods may include calculating joint velocities that achieve the desired end effector movement using a pseudo-inverse solution and adjusting the calculated joint velocities using a potential function gradient within the joint space corresponding to the desired movement of the first set of joints. Methods may include use of a weighted pseudo-inverse solution and also an augmented Jacobian solution. One or more auxiliary movements may also be provided using joint velocities calculated from the pseudo-inverse solution. Various configurations for systems utilizing such methods are provided herein.

Abstract: Instrument that is made to match the perimeter shape of a Patient Specific Knee Implant (PSKI) with features for locating holes in the distal femur such that the posts or lugs in the femoral implant locate the femoral implant centered medial-laterally within an acceptable degree of precision to prevent overhang of either the medial or lateral side of the femoral implant over the perimeter of the distal femur bone resections. Patient specific implant technology, in which a three-dimensional model of at least a portion of a bone is accessed and a three-dimensional solution volume is defined based on resection cuts used in fitting an implant on the portion of the bone. An outline representation of at least a portion of an outer surface of a periphery of the resultant bone volume is determined and the outline representation is used in one or more operations related to instrument matching.

Abstract: A drive motor of a dental handpiece for driving a cutting tool of the handpiece is provided that is connected to the dental handpiece on its front end side and includes a cylindrical casing; a rotor unit, which is rotatably supported inside the casing and outputs a driving force; a stator unit provided around the rotor unit inside the casing; and an air path which causes cooling air supplied from the rear end side of the drive motor to pass through an airtight cooling room circumferentially extending between the stator unit and the casing, and to be discharged from the rear end side.

Abstract: A dental cutting system and method for cutting a patient's tooth includes a hand piece to be held and carrying a cutting burr to cut the patient's tooth. A plurality of guide pins is attached to and extends from the hand piece of the cutting tool remote from the cutting bur. One or more cutting guides each have a cavity coinciding with at least a portion of teeth inside a patient's mouth that are adjacent to or remote from the patient's tooth to be cut. The guide pins of the handpiece slide in slots in the cutting guide to guide the cutting burr to cut the patient's tooth.

Abstract: A self-ligating bracket includes a bracket body with a mesial and a distal channel. A spring clip includes a distal arm with a distal arm body and a distal finger and a mesial arm with a mesial arm body and a mesial finger. The spring clip is slidably secured within the bracket body by a sliding engagement of the distal arm with the distal channel and the mesial arm with the mesial channel. The spring clip is movable between an open position and a closed position wherein in the open position, the arch wire slot is unobstructed and in the closed position the mesial finger and distal finger extend into and across the arch wire slot to occlude the arch wire slot.

Abstract: The present application relates to a fitting for insertion into a dental implant in an insertion orientation defining a central insertion axis (X) and an insertion direction (D) of the fitting. The fitting includes at least one resilient spring member being expandable perpendicularly to the insertion axis (X) of the fitting for impeding a movement of the fitting relative to the dental implant along the insertion axis (X) when inserted into the dental implant. It further includes an alignment feature for rotationally aligning the fitting relative to the dental implant about the insertion axis (X). The alignment feature can extend further in the insertion direction (D) than the spring member.

Abstract: Insertion tool for transmitting torque from a drive tool to a dental implant, having a tool shaft including, at its apical end a dental implant engagement section including a torque applying unit to engage the dental implant such that torque can be transmitted from the insertion tool to the implant, a drive tool engagement section coronal of the dental implant engagement section including a primary torque receiving unit to engage the drive tool such that torque can be transmitted from the drive tool to the insertion tool, and a break zone arranged between the drive tool and dental implant engagement sections and designed to break upon application of a predetermined amount of torque. The shaft includes, between the dental implant engagement section and the break zone, an auxiliary torque receiving unit to engage a drive tool such that torque can be transmitted from the drive tool to the insertion tool.

Abstract: In the case of a method for optical acquisition of the three-dimensional geometry of objects, in particular teeth (4), with a scanner (14), which has a scanning head (13), the three-dimensional geometry that is acquired in a virtual three-dimensional space (1) in the course of scanning is noted. In this case, in the course of scanning, positions of a defined scanner geometry (2) of the scanner (14), in particular of the scanning head (13), are noted relative to the object (4) that is acquired, and, moreover, an area (6) in which the defined scanner geometry (2) is or was located is determined. The determined area (6) is marked, for example as “empty,” in the virtual space (1).

Abstract: Dental prostheses and methods for making them are disclosed. In one embodiment, a method comprises a sequence of steps including milling a cavity in a block of a coping material, filling the cavity with a green ceramic material, milling a portion of the green ceramic material away to leave a layer of green ceramic material on an occlusal surface formed in the coping material, milling the underside of the block of coping material to form the coping with green ceramic material, and sintering the coping with green ceramic material to complete the prosthesis. The milling steps may be performed by a computer-controlled mill. The computer may execute a CAD-CAM program that includes data from a three dimensional model of a tooth that is to receive the prosthesis. The dental prosthesis may be a dental crown or a dental bridge.

Abstract: A floss device is disclosed which is designed to be used to floss between adjacent teeth in a person's mouth. The floss device includes a first portion joined to a second portion. The first portion has an arcuate configuration which terminates in a rounded tip. The second portion is linear and terminates in an enlarged distal end which is designed to be grasped between a person's thumb and index finger and facilitates manipulation of said floss device. The floss device also has a textured outer surface that can temporarily retain a solution or liquid medication and then transfer the solution or liquid medication onto the teeth and surrounding soft tissue in a person's mouth. A method of molding the floss device and a method of using the floss device are also disclosed.

Abstract: An electronically powered toothbrush. The toothbrush includes a brush head including a plurality of bristles, a motor, and an output shaft connected to the brush head and the motor. The output shaft is selectively rotated by the motor. The toothbrush further includes a bumper assembly connected to the output shaft and configured to conserve kinetic energy from the output shaft during rotation and reapply the kinetic energy to the output shaft.

Abstract: Described are methods, devices, and systems related to implants for the treatment of a female pelvic condition. The implants include absorbable and non-absorbable materials and can be introduced into the pelvic area transvaginally. Meshes of the invention provide benefits relating to improved tissue integration into the mesh, reduced infection likelihood, improved patient comfort following implantation, or combinations of thereof.

Abstract: A blood clot filter includes a number of locator members and anchor members, each of the members tipped with a retainer encompassed within bio-resorbable cover material. Upon delivery into a blood vessel, the locator and anchor members position the filter near the vessel centerline. After a period of time, the bio-resorbable cover material resorbs, allowing the retainer on the members to penetrate and attach to the vessel wall. A method of implanting the filter includes delivering the filter into a blood vessel and allowing the bio-resorbable cover material to resorb so retainers on the members can engage the vessel walls.

Abstract: Everting filter devices and methods for using the devices, including using the devices as intra-vascular filters to filter thrombus, emboli, and plaque fragments from blood vessels. The filter devices include a filter body nominally tubular in shape and having a large proximal opening. The filter body can extend from a proximal first end region distally over the non-everted exterior surface of the filter, further extending distally to a distal-most region, then converging inwardly and extending proximally toward the filter second end region, forming a distal everted cavity. The degree of eversion of the filter can be controlled by varying the distance between the filter first end region near the proximal opening and the closed second end region. Bringing the filter first and second end regions closer together can bring filter material previously on the non-everted filter exterior to occupy the distal-most region.

Abstract: A method for performing a percutaneous valve bypass, the method comprising providing a bypass conduit having a first end and a second end; connecting the first end of the bypass conduit to a first vascular structure at a first anastomosis; connecting the second end of the bypass conduit to a second vascular structure at a second anastomosis; advancing a percutaneous valve along the bypass conduit to a deployment site located within the bypass conduit; and deploying the percutaneous valve at the deployment site so that fluid is permitted to pass from the second vascular structure to the first vascular structure but is prevented from passing from the first vascular structure to the second vascular structure.

Abstract: Medical devices with surfaces on which viable biologic cells are magnetically attracted and retained are disclosed along with methods of magnetic coating. The medical devices can be located in a carrier liquid containing high concentrations of magnetic cells before or after implantation. The carrier liquid with magnetic cells may be contact with the medical device in vitro or in vivo. In either case, the carrier liquid may have a concentration of magnetic cells that is high enough to facilitate coating of the medical device within an acceptable period of time, e.g., several hours or less. Magnetization of medical devices before, during, and/or after implantation and apparatus for performing the same are disclosed. Degaussing of magnetic medical devices is also disclosed.

Abstract: Apparatus (10) is provided, which includes an endovascular stent-graft (20) and a heating device (22) that is coupled to the stent-graft (20). The stent-graft (20) is configured to be implanted in at least one blood vessel in a vicinity of an aneurysm (102). The heating device (22) is configured to apply, to a region (24) external to the stent-graft (20), thermal energy sufficient to coagulate blood flowing into the aneurysm (102). Other embodiments are also described.

Abstract: A tendon anchoring device may include an implant having a pair of spaced apart legs for straddling a tendon. A push rod removably attached to the implant may be utilized to guide and push a portion of the tendon into a pre-drilled bore in a bone. A fixation member may be slid along the push rod and threadably engage an inner surface of the pre-drilled bore to thereby anchor the tendon to the bone while a force is applied to the push rod. Once the fixation member has been installed, the push rod may be disengaged from the implant and removed from the bore. The implant may remain permanently straddled over the tendon inside of the bore.

Abstract: Methods for optimal breast reconstruction are disclosed. The methods include steps for performing a mastectomy that preserves a breast skin envelope. A prosthesis may be inserted into the breast and may be inflated to preserve the shape of the breast skin envelope. The prosthesis may include, a base, a balloon coupled to the base, where the balloon may be inflated to preserve the shape of the breast skin envelope. The prosthesis may also include tube coupled to port for filling the balloon to a predetermined volume. A needle-lock system, coupled to the port may be used to inject, for example, fluids into the balloon. If a patient requires post-mastectomy radiation, breast reconstruction may be delayed and the prosthesis may remain in the breast cavity during the treatment. The treatment may be external beam radiation. Alternatively, the treatment may include brachytherapy technique for treating the internal breast cavity.

Abstract: Methods for breast reconstruction and augmentation are provided which may reduce the incidence of capsular contracture. Methods for treating an encapsulated breast and reducing potential for capsular contracture in the breast are also provided.

Abstract: The invention relates to an implant device comprising a sensor module which comprises one or more first fastening means, an implant module which comprises one or more second fastening means, and a connecting module, by means of which the sensor module is connected to the implant module via the one or the first fastening means and via the one or the second fastening means, and comprising a fold axis, along which the implant device can be folded up.

Abstract: An accommodating intraocular lens (AIOL) comprising an optic, and at least one haptic plate coupled to the optic by at least one connector, the connector being less rigid than the haptic plate, the at least one haptic plate surrounding the optic, and the optic and haptic plate having a combined surface area between 70 mm2 and 100 mm2. The at least one haptic plate may form a continuous 360-degree boundary around the optic. The at least one haptic plate has a width in a radial dimension of 1.0-3.5 mm across its entire angular extent.

Abstract: Advances in filling apparatus, handheld tools, surgical techniques and intraoperative biometry for implanting and adjusting an accommodative liquid lens are disclosed. The lens may be attached to or retained within a handheld surgical tool, which can be fluidly connectable to a filling console to fill the lens with a liquid. In various embodiments, a filling console facilitates aspirating liquid out of the lens in order to ensure the absence of residual bubbles and filling of the lens with fluid during surgery, as well as during post-operative adjustments to the lens. Actuated by the surgeon, the filling console can aspirate fluid from the lens and inject fluid into the lens following insertion thereof.

Abstract: A heart valve prosthesis configured for deployment within a native heart valve. The heart valve prosthesis includes a tubular stent and a prosthetic valve component disposed within and secured to the stent. In addition, at least two positioning elements are coupled to a distal end of the stent to position and anchor the prosthesis within the native heart valve. Each positioning element transforms from a compressed configuration in which the positioning elements distally extend from the distal end of the stent to a deployed configuration in which the positioning elements proximally extend from the distal end of the stent. Each positioning element includes at least one U-shaped or V-shaped support arm that bends radially outward and then towards an outer surface of the stent such that it translates more than ninety degrees from the compressed configuration. Each positioning element may include an outer support arm and an inner support arm.

Abstract: Mitral valve prolapse and mitral regurgitation can be treating by implanting in the mitral annulus a transvalvular intraannular band. The band has a first end, a first anchoring portion located proximate the first end, a second end, a second anchoring portion located proximate the second end, and a central portion. The central portion is positioned so that it extends transversely across a coaptive edge formed by the closure of the mitral valve leaflets. The band may be implanted via translumenal access or via thoracotomy.

Abstract: A cardiac implant system including a cardiac implant such as an annuloplasty ring, a prosthetic heart valve, or a valved conduit pre-assembled at the time of manufacture with devices for securing the implant to a heart valve annulus using knotless suture fasteners. The knotless suture fasteners may be embedded within a pliant sealing edge of the cardiac implant, or they may be positioned adjacent to the sealing edge. The knotless suture fasteners are spring-biased so as to grip onto annulus anchoring sutures pass to therethrough upon removal of a restraining device, such as a hypotube inserted within the suture fasteners. Guide tubes are assembled in line with the suture fasteners to permit introduction of suture snares that pass through the suture fasteners and through the sealing edge to facilitate capture of the pre-installed annulus anchoring sutures.

Abstract: Devices and methods provide enhanced treatment of a cardiac valve annulus. Methods generally involve contacting an anchor delivery device with the valve annulus and releasing a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus. Anchors, which in some embodiments are super-elastic or shape memory self-securing anchors, are then drawn together to tighten the annulus. Devices generally include an elongate catheter having a housing at or near the distal end for releasably housing a plurality of coupled anchors. The housing may be flexible, may conform to a valve annulus, and in some embodiments may be coupled with an expandable member to enhance contact of the housing with annular tissue. In one embodiment, self-securing anchors lie approximately flat within the delivery device housing, allowing anchors with relatively large deployed shapes to be housed in and deployed from a relatively narrow delivery device.

Abstract: Disclosed is a method of engaging a bearing liner within a shell member with an integrated projection portion. The integrated projection portion may deform a selected amount during positioning of the bearing liner within the shell. The shell may include a complementary engaging portion.

Abstract: Systems, devices, and methods are provided for orthopedic implants. The implants may include a base member, such as an acetabular shell or an augment, that is configured to couple with an augment, flange cup, mounting member, or any other suitable orthopedic attachment. An implant may include abuse member that has at least two projections with a gap between the projections. The gap between the projections allows the implant to be implanted around another implanted component, such as around a bone screw of an acetabular shell. The implant may include a fixation element, such as a screw or a cement trough, on one or more projections to couple the implant to an implanted acetabular shell. The implant may also include timing marks to facilitate alignment with corresponding marks on another implanted component.

Abstract: A tibial orthopedic prosthesis assembly for use during performance of a knee replacement procedure includes one or more tibial augments configured to be coupled to a tibial tray. Each tibial augment includes an exterior side surface of varying angulation relative to a top surface of the tibial augment.

Abstract: A semi-constrained polyaxial ankle joint replacement implant has a dual bearing component, a tibial component or plate adapted for attachment to a tibia or fibula bone, and a talar component or plate adapted for attachment to a talus or calceneus bone of the foot. The dual bearing component includes a superior bearing providing gliding articulation/translation between it and the tibial component, and an inferior bearing providing gliding articulation/translation between it and the talar component. The tibial plate has peripheral transversely extending flanges that semi constrain or limit movement relative to the superior bearing and/or vice versa. The inferior bearing has a flange extending upwardly from the superior surface thereof that is received in an opening in the intermediate plate to semi constrain or limit movement relative between the two components.

Abstract: A method of reconstructing a patient's wrist. A prosthesis is provided having proximal and distal assemblies. The distal assembly has a body with a U-shaped portion. The proximal and distal assemblies have surfaces that cooperate to guide movement between the proximal and distal assemblies. The proximal assembly is fixed to the patient's radius. The hand is prepared for placement of the distal assembly by removing cartilage against a plurality of carpal bones without significantly altering the configuration of stable volume of at least one of the patient's carpal bones in the first carpal row. The U-shaped portion of the body is placed against a plurality of bones in the first carpal row. Separate locations on the body are secured to a plurality of carpal bones.

Abstract: The embodiments of the present disclosure relate to a spinal implant assembly having features to prevent or minimize fixation elements, such as screws, from being dislodged, or from backing out over time and with use. The spinal implant assembly may comprise an implantable body having first apertures for receiving fixation elements. A plate configured to nest against the posterior portion of the implantable body and comprising one or more second apertures can be provided. These second apertures permit access to the head portions of the fixation elements. One or more locking elements are then passed through the second apertures and engage the head portions of the fixation elements. In addition, the plate may comprise an adjustable arm to allow the plate to be used with implantable bodies of different size.

Abstract: An intervertebral implant includes a body portion defining a longitudinal axis. The body portion includes a distal end portion, a proximal end portion, anterior and posterior walls that extend between the distal and proximal end portions, and top and bottom surfaces. At least one of the top and bottom surfaces includes a plurality of substantially concentrically arranged ridges configured and adapted to engage vertebral bodies. In particular, the plurality of substantially concentrically arranged ridges are a plurality of ring-shaped protrusions that define a generally saw-tooth pattern in a radial direction.

Abstract: A system and methods for promoting fusion across an intervertebral disc space, the system including a system of spinal fusion implants including a distal implant, a proximal implant and a medial implant positioned therebetween, wherein the medial implant has a flexible anterior wall capable of being deformed when a force is exerted upon it.

Abstract: A methodology for grafting together adjacent bony structures is provided using an implant device having an endplate with an inner disc portion and outer ring portion spaced from the inner disc portion by a connecting wall disposed there between. An endplate interior surface includes a retaining structure for securing the endplate to one of the bony structures, and endplate an exterior surface has an integrally formed socket. A ball-joint rod has a longitudinally extending body and an end, and at least a portion of the ball-joint rod end is curvilinear in shape. The curvilinear ball-joint rod end is rotatably disposed in the endplate socket to fixedly interconnect the bony structures.

Abstract: A surgical apparatus includes an orientation sensor that detects an actual orientation of a surgical tool. The apparatus also includes a tactile orientation feedback device that selectively provides a tactile orientation feedback signal. Moreover, the apparatus includes a controller that causes the tactile orientation feedback device to provide the tactile orientation feedback signal when the actual orientation of the surgical tool detected by the orientation sensor is substantially equal to a predetermined target orientation of the surgical tool.

Abstract: Vertebral body replacements are provided, including at least one vertebral body replacement in the shape of an oblong object. The oblong vertebral body replacement includes a nose shape to provide as minimally invasive an installation as possible, serrations formed in the side wall of the body replacement's body to prevent expulsion once the body replacement is in place, a tapered asymmetric shape to provide spinal lordosis, and an integral protrusion for stability and to increase the bearing area to reduce contact pressure between the body replacement and the vertebral plate. Hollow passages are typically filled with bone tissue. The body is also provided with holes passing therethrough to promote tissue growth.

Abstract: An articulated mechanism system includes a plurality of fingers (articulated mechanisms) arranged in parallel, each of which has a mounting member, a first digital part rotatably connected to the mounting member by a first connecting part, a second digital part rotatably connected to the first digital part by a second connecting part, and a first driving part rotatably connected to the second digital part by a fourth connecting part and connected to a third connecting part. By extruding the third connecting part toward the fourth connecting part, the first digital part and the second digital part are integrally rotated about the first connecting part, or the second digital part is rotated about the second connecting part when the rotation of the first digital part is blocked. The third connecting parts are driven by a single driving mechanism for the same distance and in the same direction at a time.

Abstract: A noninvasive brain computer interface (BCI) system includes an electroencephalography (EEG) electrode array configured to acquire EEG signals generated by a subject. The subject observes movement of a stimulus. A computer is coupled to the EEG electrode array and configured to collected and process the acquired EEG signals. A decoding algorithm is used that analyzes low-frequency (delta band) brain waves in the time domain to continuously decode neural activity associated with the observed movement.

Abstract: A moisture management liner device for a prosthetic socket may include an elongate, cup-shaped, elastomeric member and multiple fluid transport strips. The elastomeric member may include a first material and may extend from an open proximal end to a substantially closed distal end. The substantially closed distal end may include a fluid exit aperture to allow fluid to pass out of the liner device. The fluid transport strips may include a second material and may be disposed at spaced-apart intervals around a circumference of an internal surface of the elastomeric member, over at least a distal portion of the elastomeric member. The fluid transport strips may be configured to facilitate passage of fluid out of the liner device through the fluid exit aperture.

Abstract: The invention relates to a prosthetic socket for a residual limb of the lower extremity or upper extremity of an individual person. The residual limb has particular dimensions and anatomical contours; the prosthetic socket has dimensions and contours that fit the dimensions and contours of the residual limb. The prosthetic socket may also fit in a manner that is biomechanically particularly appropriate for the individual. The prosthetic socket is an assembly of components from groups of components that include (a) struts arranged longitudinally with respect to the residual limb, (b) proximal brim members arranged proximally to the struts and connected thereto; and (c) distal socket members disposed at the distal base of the prosthetic socket. The socket components within these groups may be modular in that they can vary with respect to dimensions and/or contours, and yet have common connecting features that permit assembly of the components together to form the prosthetic socket.

Abstract: The present disclosure relates to an endoluminal prosthesis, such as a stent graft that includes one or more fenestrations to accommodate endovascular disease, such as an aneurysm in cases where one or more side branches is involved. In one aspect, the prosthesis includes fenestrations that are pivotable to accommodate the dynamic geometry of the aortic branches. In another aspect, the pivotable fenestrations include a first perimeter, a band of flexible material attached and surrounding the first perimeter, and a second perimeter attached to and surrounding the band of flexible material. The first perimeter, band of flexible material, and second perimeter have a geometric shape. In one aspect, the prosthesis includes at least three pivotable fenestrations.

Abstract: A bifurcated graft including a first branch having a first leg graft; a second branch having a second leg graft spaced apart from and not overlapping the first leg graft; and a trunk including a first layer having a first portion, a second portion, and a saddle extending therebetween the first portion and the second portion. Each of the first portion and second portion have opposite side edges that are spaced apart to define a first width. The saddle has opposite sides that are spaced apart to define a second width. The second width of the saddle is less than the first width of each of the first portion and second portion. The saddle extends along a bifurcation between the first leg graft and second leg graft.