| CPC A61F 2/2418 (2013.01) [A61F 2/243 (2013.01); A61F 2220/0008 (2013.01); A61F 2220/0075 (2013.01)] | 11 Claims |

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1. A prosthetic heart valve, comprising:
an expandable inner stent having an inflow end and an outflow end;
an expandable outer stent having an atrial end and a ventricular end, the outer stent being secured to and at least partially surrounding the inner stent;
a valve assembly disposed within the inner stent, the valve assembly including a cuff and a plurality of leaflets;
a tether connector positioned at the inflow end of the inner stent and also along a central longitudinal axis of the inner stent when the inner stent is in an expanded condition; and
a tether having a first end and a second end remote from the first end, the first end of the tether being secured to the tether connector so that a length of the tether between the first end and the second end extends along the central longitudinal axis,
wherein the plurality of leaflets are positioned relative to the tether such that, in an implanted condition of the prosthetic heart valve, the plurality of leaflets are configured to close around the tether during ventricular systole.
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