A replacement heart valve prosthesis for deployment at a native mitral heart valve, the prosthesis (6500; 6600) comprising: an expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100) configured to radially expand and contract for deployment within a native heart valve, the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100) comprising: a frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a) comprising a proximal region (6527; 6710), a distal region (6529; 6730), and an intermediate region (6528; 6720) extending between the proximal and distal regions (6527; 6710; 6529; 6730), the frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a) comprising a first row of struts and a second row of struts; a supplemental frame (6522b; 6622b; 6702b; 6810b; 6910b; 7010b; 711 0b) comprising a first row of struts configured to be generally aligned along the first row of struts of the frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a), the first row of struts of the supplemental frame (6522b; 6622b; 6702b; 6810b; 6910b; 7010b; 7110b) having a shape which generally matches the shape of the first row of struts of the frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a); and a distal anchoring feature (6526; 6628; 6632; 6740; 6830; 6930; 7030) the distal anchoring feature (6526; 6628; 6632; 6740; 6830; 6930; 7030) sized to be positioned on a ventricular side of a native mitral valve annulus, the distal anchoring feature (6526; 6628; 6632; 6740; 6830; 6930; 7030) including one or more anchors, each anchor including one or more struts extending from an intermediate region and/or lower region of the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100), the struts extending generally downwardly from the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100), incorporating a bend to orient the strut such that it extends radially outward away from the longitudinal axis of the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100) and generally upwardly; and a valve body (6540; 6640) positioned within an interior of the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100), the valve body (6540; 6640) comprising a plurality of leaflets (6542; 6642) configured to allow flow in a first direction and prevent flow in a second opposite direction. a frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a) comprising a proximal region (6527; 6710), a distal region (6529; 6730), and an intermediate region (6528; 6720) extending between the proximal and distal regions (6527; 6710; 6529; 6730), the frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a) comprising a first row of struts and a second row of struts; a supplemental frame (6522b; 6622b; 6702b; 6810b; 6910b; 7010b; 711 0b) comprising a first row of struts configured to be generally aligned along the first row of struts of the frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a), the first row of struts of the supplemental frame (6522b; 6622b; 6702b; 6810b; 6910b; 7010b; 7110b) having a shape which generally matches the shape of the first row of struts of the frame body (6522a; 6622a; 6702a; 6810a; 6910a; 7010a; 7110a); and a distal anchoring feature (6526; 6628; 6632; 6740; 6830; 6930; 7030) the distal anchoring feature (6526; 6628; 6632; 6740; 6830; 6930; 7030) sized to be positioned on a ventricular side of a native mitral valve annulus, the distal anchoring feature (6526; 6628; 6632; 6740; 6830; 6930; 7030) including one or more anchors, each anchor including one or more struts extending from an intermediate region and/or lower region of the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100), the struts extending generally downwardly from the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100), incorporating a bend to orient the strut such that it extends radially outward away from the longitudinal axis of the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100) and generally upwardly; and a valve body (6540; 6640) positioned within an interior of the expandable frame (6520; 6620; 6700; 6800; 6900; 7000; 7100), the valve body (6540; 6640) comprising a plurality of leaflets (6542; 6642) configured to allow flow in a first direction and prevent flow in a second opposite direction.