Transcatheter heart valves with improved blood flow

An apparatus comprising a prosthetic valve for deployment in a native atrioventricular valve, the prosthetic valve comprising:

• three prosthetic valve leaflets positioned about a flow channel of the prosthetic valve, each of the prosthetic valve leaflets including:
• two commissure ends, and
• a central portion positioned between the commissure ends;
• wherein the three leaflets are attached to form three commissure regions at which one of the commissure ends of one of the leaflets meets one of the commissure ends of another one of the leaflets;
• a valve frame to which the three commissure regions are affixed for supporting the prosthetic valve leaflets, wherein the valve frame provides three openings between the three commissure regions;
• and
• an outer sealing frame having an upstream portion and a downstream portion, the sealing frame being coupled to the valve frame such that, once the prosthetic valve has been deployed in the native atrioventricular valve:
• the downstream portion is spaced radially outward from the valve frame to engage and seal against the native atrioventricular valve while defining a gap between the downstream portion and the valve frame, and
• ventricular blood passes along radially outward facing surfaces of the prosthetic valve leaflets and through the openings into the gap in a manner that washes out the downstream portion to reduce thrombus formation.