A prosthetic heart valve may include a valve assembly disposed within a stent, and first and second cuffs. The stent may extend in a longitudinal direction from an inflow end to an outflow end. The first cuff may be annularly disposed adjacent the stent. The second cuff may have a proximal edge facing toward the inflow end of the stent and a distal edge facing toward the outflow end of the stent. The second cuff may be annularly disposed about the stent radially outward of the first cuff. The distal edge of the second cuff may be coupled to the first cuff and/or the stent at a plurality of locations to form a pocket(s) between the first and second cuffs. The proximal edge of the second cuff may be coupled to first cuff and/or to the stent at a spaced distance from the inflow end of the stent.
