Thrombus management and structural compliance features for prosthetic heart valves

A prosthetic heart valve comprising:

• an outer frame assembly having an atrium portion, a ventricle portion, and an annulus portion between the atrium portion and the ventricle portion,
• the ventricle portion having a maximum perimeter larger than a maximum perimeter of the annulus portion,
• the ventricle portion having a minimum perimeter smaller than a minimum perimeter of the annulus portion,
• the annulus portion having an hourglass shape with a minimum perimeter disposed between a larger perimeter near the atrium portion and a larger perimeter near the ventricle portion;
• an inner valve assembly including an inner frame having an atrium end and a ventricle end,
• the inner valve assembly coupled to the outer frame assembly by a connection between the ventricle end of the inner frame and the ventricle portion of the outer frame assembly,
• the inner frame assembly extending from the connection towards the atrium portion of the outer frame assembly,
• the inner frame assembly and the outer frame assembly diverging from the connection towards the atrium portion of the outer frame assembly,
• the annulus portion of the outer frame assembly being spaced radially from the inner valve assembly and radially inwardly deflectable towards the inner valve assembly to accommodate in the annulus portion a natural valve annulus having a perimeter smaller than the minimum perimeter of the annulus portion.

A prosthetic heart valve comprising:

• an outer frame assembly having an atrium portion, a ventricle portion, and an annulus portion between the atrium portion and the ventricle portion;
• an inner valve assembly including an inner frame having an atrium end and a ventricle end,
• the inner valve assembly coupled to the outer frame assembly by a connection between the ventricle end of the inner frame and the ventricle portion of the outer frame assembly,
• the inner frame assembly extending from the connection towards the atrium portion of the outer frame assembly,
• the inner frame assembly and the outer frame assembly diverging from the connection towards the atrium portion of the outer frame assembly,
• the annulus portion and the atrium portion of the outer frame assembly being spaced radially from the inner valve assembly and being radially inwardly deflectable towards the inner valve assembly,
• each of the atrium portion, the ventricle portion, and the annulus portion of the outer frame assembly having a stiffness in resistance to radial compression, the stiffness of the annulus portion being less than the stiffness of the ventricle portion.