Devices, systems and methods to position a prosthetic heart valve such that the prosthetic valve does not compress conduction tissue and thereby produce heart block. Guide devices promote positioning the prosthetic valve within a native aortic valve to avoid the conduction tissue and, optionally, to center the prosthetic valve within the native heart valve. Prosthetic valves include one or more cut-outs, openings or recesses configured to align with the conduction tissue so that the conduction tissue is not contacted in a way that would lead to higher incidents of complete heart block.
