Replacement heart valves and methods of delivery

A valve prosthesis configured to be deployed within a native heart valve at a native heart valve annulus, the valve prosthesis comprising:

• an expandable frame comprising a proximal end, a distal end, a middle portion between the proximal end and the distal end, and a longitudinal axis extending therethrough, the frame configured to collapse radially for delivery and to expand radially upon deployment;
• a plurality of circumferentially spaced apart distal anchors extending from the distal end of the frame towards the proximal end and expandable from a collapsed configuration to an expanded configuration, each of the plurality of circumferentially spaced apart distal anchors covered at least partially by a cushion;
• a plurality of tips having enlarged ends extending from the proximal end and configured to engage a locking mechanism of a delivery system for the prosthesis, wherein when the valve prosthesis is expanded at the native heart valve the plurality of tips are configured to be located on a first side of the native heart valve annulus and the plurality of circumferentially spaced apart distal anchors are configured to be located on a second side of the native heart valve annulus;
• a valve body positioned within an interior of the expandable frame, wherein the valve body comprises a plurality of leaflets configured to allow flow in a first direction and prevent flow in a second opposite direction;
• a flap assembly positioned around and secured to an exterior of the expandable frame;
• and
• a biasing outer portion positioned radially outward and extending circumferentially around the middle portion of the frame when the frame is in an expanded configuration, the biasing outer portion being configured to bias the flap assembly radially outward from the longitudinal axis of the frame to provide a space having a distal opening between the flap assembly and the valve body;
• wherein when fluid flows into the space, the flap assembly creates a barrier to fluid flow exterior to the middle portion of the frame when the valve prosthesis is deployed within the native heart valve.