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Russian Journal of Cardiology

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2025 Clinical practice guidelines for Aortic insufficiency

https://doi.org/10.15829/1560-4071-2026-6866

EDN: HVDXQT

Abstract

With the participation of: the Russian Society for Cardiosomatic Rehabilitation and Secondary Prevention, the Russian Society of Radiologists and Radiologists, the Russian Scientific Society of Specialists in X-ray Endovascular Diagnostics and Treatment, the All-Russian Public Organization for the Promotion of Radiation Diagnostics and Therapy

Approved by the Research and Practical Council of the Ministry of Health of the Russian Federation (13.11.2025)

Task Force members declared no financial support/conflicts of interest. If conflicts of interest were reported, the member(s) of the working group was (were) excluded from the discussion of the sections related to the area of conflict of interest.

About the Authors

L. A. Bokeria
АССХ
Russian Federation

Competing Interests:

none



V. E. Uspensky
РКО; АССХ
Russian Federation

Competing Interests:

none



E. V. Kutz
АССХ
Russian Federation

Competing Interests:

none



O. B. Irtyuga
РКО
Russian Federation

Competing Interests:

none



S. A. Alexandrova
РОРР
Russian Federation

Competing Interests:

none



B. G. Alekyan
РНО РДиЛ
Russian Federation

Competing Interests:

none



R. A. Amiragov
АССХ
Russian Federation

Competing Interests:

none



D. M. Aronov
РКО; РосОКР
Russian Federation

Competing Interests:

none



T. V. Asatryan
АССХ
Russian Federation

Competing Interests:

none



M. V. Babakekhyan
РКО
Russian Federation

Competing Interests:

none



K. O. Barbukhatti
АССХ
Russian Federation

Competing Interests:

none



A. V. Bogachev-Prokofiev
РКО; АССХ
Russian Federation

Competing Interests:

none



S. A. Boytsov
РКО
Russian Federation

Competing Interests:

none



M. G. Bubnova
РКО; РосОКР
Russian Federation

Competing Interests:

none



M. L. Gordeev
РКО; АССХ
Russian Federation

Competing Interests:

none



R. K. Georgikia
АССХ
Russian Federation

Competing Interests:

none



A. V. Dorofeev
РОРР
Russian Federation

Competing Interests:

none



S. I. Zheleznev
АССХ
Russian Federation

Competing Interests:

none



T. E. Imaev

Russian Federation

Competing Interests:

none



S. V. Kalashnikov
АССХ
Russian Federation

Competing Interests:

none



A. M. Karaskov
АССХ
Russian Federation

Competing Interests:

none



S. A. Kovalev
АССХ
Russian Federation

Competing Interests:

none



B. N. Kozlov
АССХ
Russian Federation

Competing Interests:

none



A. E. Komlev
РКО
Russian Federation

Competing Interests:

none



S. T. Matskeplishvili
РКО
Russian Federation

Competing Interests:

none



N. N. Meleshenko
РНО РДиЛ
Russian Federation

Competing Interests:

none



V. A. Mironenko
АССХ
Russian Federation

Competing Interests:

none



M. Yu. Mironenko
РОРР
Russian Federation

Competing Interests:

none



R. M. Muratov
АССХ
Russian Federation

Competing Interests:

none



T. G. Nikitina

Russian Federation

Competing Interests:

none



K. V. Petrosyan
РНО РДиЛ
Russian Federation

Competing Interests:

none



N. V. Pogosova
РКО
Russian Federation

Competing Interests:

none



A. V. Protopopov
РНО РДиЛ
Russian Federation

Competing Interests:

none



M. Yu. Pugina
РКО
Russian Federation

Competing Interests:

none



E. V. Rosseikin
АССХ
Russian Federation

Competing Interests:

none



V. E. Sinitsyn
РОРР
Russian Federation

Competing Interests:

none



I. I. Skopin
АССХ
Russian Federation

Competing Interests:

none



I. V. Sukhova
РКО
Russian Federation

Competing Interests:

none



D. G. Tarasov
АССХ
Russian Federation

Competing Interests:

none



A. R. Tarkova
РОРР
Russian Federation

Competing Interests:

none



I. Yu. Farulova
РОРР
Russian Federation

Competing Interests:

none



G. G. Khubulava
АССХ
Russian Federation

Competing Interests:

none



E. R. Charchyan
АССХ
Russian Federation

Competing Interests:

none



I. I. Chernov
АССХ
Russian Federation

Competing Interests:

none



E. V. Shlyakhto
РКО
Russian Federation

Competing Interests:

none



Yu. A. Shneider
АССХ
Russian Federation

Competing Interests:

нет



L. A. Yurpolskaya
РОРР
Russian Federation

Competing Interests:

none



References

1. Bekeredjian R, Grayburn PA. Valvular heart disease: aortic regurgitation. Circulation. 2005;112(1):125-34. doi:10.1161/CIRCULATIONAHA.104.488825.

2. Maurer G. Aortic regurgitation. Heart. 2006;92(7):994-1000. doi:10.1136/hrt.2004.042614.

3. Weiss RM, Miller JD, Heistad DD. Fibrocalcific aortic valve disease: opportunity to understand disease mechanisms using mouse models. Circ Res. 2013;113(2):209-22. doi:10.1161/CIRCRESAHA.113.300153.

4. Pugina MY, Gareev DA, Korzhova MA, et al. Pathomorphological features of complications inpatients with bicuspid aortic valve. South Russian Journal of Therapeutic Practice. 2023;4(3):62-9. (In Russ.) doi:10.21886/2712-8156-2023-4-3-62-69. EDN: FYYAZR.

5. Irtyuga O, Kopanitsa G, Kostareva A, et al. Application of Machine Learning Methods to Analyze Occurrence and Clinical Features of Ascending Aortic Dilatation in Patients with and without Bicuspid Aortic Valve. J Pers Med. 2022;12(5):794. doi:10.3390/jpm12050794.

6. Esmaeilzadeh M, Alimi H, Maleki M, Hosseini S. Aortic valve injury following blunt chest trauma. Res Cardiovasc Med. 2014;3(3):e17319. doi:10.5812/cardiovascmed.17319.

7. Khubulava GG, Marchenko SP, Starchik DA, et al. Geometric and morphological features of the aortic root in norm and aortic regurgitation. N.I. Pirogov Surgery Journal. 2018;(5):4-12. (In Russ.) doi:10.17116/hirurgia201854-12. EDN: XPMGZV.

8. Lancellotti P, Tribouilloy C, Hagendorff A, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). Eur J Echocardiogr. 2010;11(3):223-44. doi:10.1093/ejechocard/jeq030.

9. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129(23):2440-92. doi:10.1161/CIR.0000000000000029.

10. Chaliki HP, Mohty D, Avierinos JF, et al. Outcomes after aortic valve replacement in patients with severe aortic regurgitation and markedly reduced left ventricular function. Circulation. 2002;106(21):2687-93. doi:10.1161/01.cir.0000038498.59829.38.

11. Sambola A, Tornos P, Ferreira-Gonzalez I, Evangelista A. Prognostic value of preoperative indexed end-systolic left ventricle diameter in the outcome after surgery in patients with chronic aortic regurgitation. Am Heart J. 2008;155(6):1114-20. doi:10.1016/j.ahj.2007.12.025.

12. Stefano G, Fox K, Schluchter M, Hoit BD. Prevalence of unsuspected and significant mitral and aortic regurgitation. J Am Soc Echocardiogr. 2008;21(1):38-42. doi:10.1016/j.echo.2007.05.006.

13. Zoghbi WA, Adams D, Bonow RO, et al. Recommendations for noninvasive evaluation of native valvular regurgitation: A report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2017;30(4):303-371. doi:10.1016/j.echo.2017.01.007.

14. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2021;143(5):e72-e227. doi:10.1161/CIR.0000000000000923.

15. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). European heart journal. 2021.

16. Goldstein SA, Evangelista A, Abbara S, et al. Multimodality imaging of diseases of the thoracic aorta in adults: from the American Society of Echocardiography and the European Association of Cardiovascular Imaging: endorsed by the Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance. Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography. 2015;28(2):119-82.

17. Doherty JU, Kort S, Mehran R, et al. ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 appropriate use criteria for multimodality imaging in valvular heart disease: A report of the American College of Cardiology appropriate use criteria task force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. Journal of the American College of Cardiology. 2017;70(13):1647-72.

18. de Kerchove L, El Khoury G. Anatomy and pathophysiology of the ventriculo-aortic junction: implication in aortic valve repair surgery. Annals of cardiothoracic surgery. 2013;2(1):57-64.

19. AHA/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology. 2017.

20. Attenhofer Jost CH, Turina J, Mayer K, et al. Echocardiography in the evaluation of systolic murmurs of unknown cause. The American journal of medicine. 2000;108(8):614-20.

21. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European heart journal. 2017;38(36):2739-91.

22. Cardiology. National leadership. Short edition. Edited by E.V. Shlyakhto, Moscow: GEOTARMedia; 2019. 816 p. (In Russ.) Кардиология. Национальное руководство. Краткое издание. Под редакцией Шляхто Е.В. М.: ГЭОТАР-Медиа; 2019. 816 p.

23. Tutar E, Ekici F, Atalay S, Nacar N. The prevalence of bicuspid aortic valve in newborns by echocardiographic screening. American heart journal. 2005;150(3):513-5.

24. Stout KK, Verrier ED. Acute valvular regurgitation. Circulation. 2009;119(25):3232-41.

25. Bruckner BA, Reardon MJ. Bicuspid aortic valve and associated aortopathy: surgical considerations. Methodist Debakey Cardiovasc J. 2010;6(1):29-32.

26. Agozzino L, Falco A, De Luca Tupputi Schinosa L, et al. Surgical pathology of the aortic valve: a morphologic study on 912 surgically excised valves. Giornale italiano di cardiologia. 1992;22(10):1169-77.

27. Maganti K, Rigolin VH, Sarano ME, Bonow RO. Valvular heart disease: diagnosis and management. Mayo Clinic proceedings. 2010;85(5):483-500.

28. Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. The Journal of thoracic and cardiovascular surgery. 2007;133(5):1226-33.

29. Angelini A, Ho SY, Anderson RH, et al. The morphology of the normal aortic valve as compared with the aortic valve having two leaflets. The Journal of thoracic and cardiovascular surgery. 1989;98(3):362-7.

30. Drozdov DV, Makarov LM, Barkan VS, et al. Resting 12-lead electrocardiography for adults and children. 2023 Guidelines. Russian Journal of Cardiology. 2023;28(10):5631. (In Russ.) doi:10.15829/15604071-2023-5631. EDN: JAVUJL.

31. Praz F, Borger MA, Lanz J, et al. 2025 ESC/EACTS Guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg. 2025;67(8):ezaf276. doi:10.1093/ejcts/ezaf276.

32. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2021;42(36):3599-726. doi:10.1093/eurheartj/ehab368.

33. Graffeo JM, Persaud H. Aortic regurgitation. Journal of the American Academy of PAs. 2017;30(8):47-8.

34. Oztunç F, Babaoğlu K, Yilmaz E, et al. Predictive value of cardiothoracic ratio as a marker of severity of aortic regurgitation and mitral regurgitation. Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology. 2007;7(2):146-9.

35. Matskeplishvili ST, Saidova MA, Mironenko MYu, et al. Standard transthoracic echocardiography. Guidelines 2024. Russian Journal of Cardiology. 2025;30(2):6271. (In Russ.) doi:10.15829/1560-40712025-6271. EDN: TNLDFN.

36. Lancellotti P, Tribouilloy C, Hagendorff A, et al. Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. European Heart Journal cardiovascular Imaging. 2013;14(7):611-44.

37. Lancellotti P, Rosenhek R, Pibarot P, et al. ESC Working Group on Valvular Heart Disease position paper — heart valve clinics: organization, structure, and experiences. European Heart Journal. 2013;34(21):1597-606.

38. Magne J, Cosyns B, Popescu BA, et al. Distribution and prognostic significance of left ventricular global longitudinal strain in asymptomatic significant aortic stenosis: an individual participant data meta-analysis. JACC Cardiovascular imaging. 2019;12(1):84-92.

39. Erbel R, Aboyans V, Boileau C, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). European heart journal. 2014;35(41):2873-926.

40. Borger MA, Fedak PWM, Stephens EH, et al. The American Association for Thoracic Surgery consensus guidelines on bicuspid aortic valve-related aortopathy: Full onlineonly version. The Journal of thoracic and cardiovascular surgery. 2018;156(2):e41-e74.

41. Kammerlander AA, Wiesinger M, Duca F, et al. Diagnostic and prognostic utility of cardiac magnetic resonance imaging in aortic regurgitation. JACC Cardiovascular imaging. 2019;12(8 Pt 1):1474-83.

42. Amsallem M, Ou P, Milleron O, et al. Comparative assessment of ascending aortic aneurysms in Marfan patients using ECG-gated computerized tomographic angiography versus trans-thoracic echocardiography. International journal of cardiology. 2015;184:22-7.171

43. Freeman LA, Young PM, Foley TA, et al. CT and MRI assessment of the aortic root and ascending aorta. AJR American journal of roentgenology. 2013;200(6):W581-92.

44. Azevedo CF, Nigri M, Higuchi ML, et al. Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease. Journal of the American College of Cardiology. 2010;56(4):278-87.

45. Bing R, Cavalcante JL, Everett RJ, et al. Imaging and impact of myocardial fibrosis in aortic stenosis. JACC Cardiovascular imaging. 2019;12(2):283-96.

46. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European heart journal. 2019;40(2):87-165.

47. Gatti M, Gallone G, Poggi V, et al. Diagnostic accuracy of coronary computed tomography angiography for the evaluation of obstructive coronary artery disease in patients referred for transcatheter aortic valve implantation: a sys tematic review and meta-analysis. Eur Radiol. 2022;32:5189-200. doi:10.1007/s00330-022-08603-y.

48. Diller GP, Gerwing M, Boroni Grazioli S, et al. Utility of coronary computed tomography angiography in patients undergoing transcatheter aortic valve implantation: a metaanalysis and meta-regression based on published data from 7458 patients. J Clin Med. 2024;13:631. doi:10.3390/jcm13020631.

49. Kondoleon NP, Layoun H, Spilias N, et al. Effectiveness of pre-TAVR CTA as a screening tool for significant CAD before TAVR. JACC Cardiovasc Interv. 2023;16:1990-2000. doi:10.1016/j.jcin.2023.05.030.

50. Chieffo A, Giustino G, Spagnolo P, et al. Routine screening of coronary artery disease with computed tomographic coronary angiography in place of invasive coronary angiography in patients undergoing transcatheter aortic valve replacement. Circ Cardiovasc Interv. 2015;8:e002025. doi:10.1161/circinterventions.114.002025.

51. Barili F, Pacini D, Capo A, et al. Does EuroSCORE II perform better than its original versions? A multicentre validation study. European heart journal. 2013;34(1):22-9.

52. Shahian DM, Jacobs JP, Badhwar V, et al. The Society of Thoracic Surgeons 2018 adult cardiac surgery risk models: part 1-background, design considerations, and model development. The Annals of thoracic surgery. 2018;105(5):1411-8.

53. Kundi H, Popma JJ, Reynolds MR, et al. Frailty and related outcomes in patients under- going transcatheter valve therapies in a nationwide cohort. European heart journal. 2019;40(27):2231-9.

54. Hosler QP, Maltagliati AJ, Shi SM, et al. A practical two-stage frailty assessment for older adults undergoing aortic valve replacement. J Am Geriatr Soc. 2019;67(10):2031-7.

55. Dent E, Martin FC, Bergman H, et al. Management of frailty: opportunities, challenges, and future directions. Lancet (London, England). 2019;394(10206):1376-86.

56. Goldfarb M, Lauck S, Webb JG, et al. Malnutrition and mortality in frail and non-frail older adults undergoing aortic valve replacement. Circulation. 2018;138(20):2202-11.

57. Yanagisawa R, Tanaka M, Yashima F, et al. Frequency and consequences of cognitive impairment in patients underwent transcatheter aortic valve implantation. The American journal of cardiology. 2018;122(5):844-50.

58. Abramowitz Y, Kazuno Y, Chakravarty T, et al. Concomitant mitral annular calcification and severe aortic stenosis: prevalence, characteristics and outcome following transcatheter aortic valve replacement. European heart journal. 2017;38(16):1194-203.

59. Abramowitz Y, Jilaihawi H, Chakravarty T, et al. Porcelain aorta: a comprehensive review. Circulation. 2015;131(9):827-36.

60. Puri R, Iung B, Cohen DJ, Rodés-Cabau J. TAVI or No TAVI: identifying patients unlikely to benefit from transcatheter aortic valve implantation. European heart journal. 2016;37(28):2217-25.

61. Gunter RL, Kilgo P, Guyton RA, et al. Impact of preoperative chronic lung disease on survival after surgical aortic valve replacement. The Annals of thoracic surgery. 2013;96(4):1322-8.

62. Allende R, Webb JG, Munoz-Garcia AJ, et al. Advanced chronic kidney disease in patients undergoing transcatheter aortic valve implantation: insights on clinical outcomes and prognostic markers from a large cohort of patients. European heart journal. 2014;35(38): 2685-96.

63. Tirado-Conte G, Rodés-Cabau J, Rodríguez-Olivares R, et al. Clinical outcomes and prognosis markers of patients with liver disease undergoing transcatheter aortic valve replacement: a propensity score-matched analysis. Circ Cardiovasc Interv. 2018;11(3):e005727.

64. Yang LT, Michelena HI, Scott CG, et al. Outcomes in chronic hemodynamically significant aortic regurgitation and limitations of current guidelines. Journal of the American College of Cardiology. 2019;73(14):1741-52.

65. Gerber MA, Baltimore RS, Eaton CB, et al. Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation. 2009;119(11):1541-51.

66. Elder DH, Wei L, Szwejkowski BR, et al. The impact of renin-angiotensin-aldosterone system blockade on heart failure outcomes and mortality in patients identified to have aortic regurgitation: a large population cohort study. Journal of the American College of Cardiology. 2011;58(20):2084-91.

67. Seferovic PM, Ponikowski P, Anker SD, et al. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2019;21(10):1169-86.

68. Demin AA, Kobalava ZhD, Skopin II, et al. Infectious endocarditis and infection of intracardiac devices in adults. Clinical guidelines 2021. Russian Journal of Cardiology. 2022;27(10):5233. (In Russ.) doi:10.15829/1560-40712022-5233. EDN: DCXUXV.

69. Kobalava ZhD, Konradi AO, Nedogoda SV, et al. 2024 Clinical practice guidelines for Hypertension in adults. Russian Journal of Cardiology. 2024;29(9):6117. (In Russ.) doi:10.15829/1560-4071-2024-6117. EDN: GUEWLU.

70. Ezhov MV, Kukharchuk VV, Sergienko IV, et al. Disorders of lipid metabolism. Clinical Guidelines 2023. Russian Journal of Cardiology. 2023;28(5):5471. (In Russ.) doi:10.15829/1560-4071-2023-5471.

71. Galyavich AS, Tereshchenko SN, Uskach TM, et al. 2024 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2024;29(11):6162. (In Russ.) doi:10.15829/1560-4071-2024-6162. EDN: WKIDLJ.

72. Otto CM. Heartbeat: beta-blockers for aortic regurgitation. Heart (British Cardiac Society). 2016;102(3):165-7.

73. Groenink M, den Hartog AW, Franken R, et al. Losartan reduces aortic dilatation rate in adults with Marfan syndrome: a randomized controlled trial. European heart journal. 2013;34(45):3491-500.

74. Mullen M, Jin XY, Child A, et al. Irbesartan in Marfan syndrome (AIMS): a double-blind, placebo-controlled randomised trial. Lancet (London, England). 2019;394(10216):2263-70.

75. Heneghan C, Ward A, Perera R, et al. Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data. Lancet (London, England). 2012;379(9813):322-34.

76. Irtyuga OB, Lyapina IN, Vorobyova NA, et al. Expert opinion on key aspects of managing education school for patients taking vitamin K antagonists. Russian Journal of Cardiology. 2025;30(9):6529. (In Russ.) EDN: IXXQFC.

77. Shpilevoy NYu, Vavilov PA, Belova AE. Immediate and long-term results of aortic valve replacement with modern bicuspid prostheses On-X and MedInj-2. Russian Medical Journal. 2011;17(4):22-7. (In Russ.) EDN: NZSFNZ.

78. Vavilov PA. Cardiac valve prosthesis "MedEng-2": 10 years experience of clinical application. Russian Journal of Transplantology and Artificial Organs. 2010;12(3):29-35. (In Russ.)

79. Laffort P, Roudaut R, Roques X, et al. Early and long-term (one-year) effects of the association of aspirin and oral anticoagulant on thrombi and morbidity after replacement of the mitral valve with the St. Jude medical prosthesis: a clinical and transesophageal echocardiographic study. Journal of the American College of Cardiology. 2000;35(3):739-46.

80. Sousa-Uva M, Head SJ, Milojevic M, et al. 2017 EACTS Guidelines on perioperative medication in adult cardiac surgery. European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery. 2018;53(1):5-33.

81. Raffaele De Caterina R, Agewall S, et al. Great Debate: Triple antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting should be limited to 1 week. Eur Heart J. 2022;43(37):3512-27.

82. Hansen ML, Sørensen R, Clausen MT, et al. Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Archives of internal medicine. 2010;170(16):1433-41.

83. Averkov OV, Harutyunyan GK, Duplyakov DV, et al. Acute myocardial infarction with ST segment elevation electrocardiogram. Clinical guidelines 2024. Russian Journal of Cardiology. 2025;30(3):6306. (In Russ.) doi:10.15829/1560-4071-2025-6306. EDN: IVJCUK.

84. Barbarash OL, Karpov YuA, Panov AV, et al. 2024 Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2024;29(9):6110. (In Russ.)

85. Gibson CM, Mehran R, Bode C, et al. Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. N Engl J Med. 2016;375(25):2423-34. doi:10.1056/NEJMoa1611594.

86. Pocar M, Di Mauro A, Passolunghi D, et al. Predictors of adverse events after surgical ventricular restoration for advanced ischaemic cardiomyopathy. Eur J Cardiothorac Surg. 2010;37(5):1093-100. doi:10.1016/j.ejcts.2009.12.006.

87. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. European heart journal. 2020;42(5):373-498.

88. Malik AH, Yandrapalli S, Aronow WS, et al. Oral anticoagulants in atrial fibrillation with valvular heart disease and bioprosthetic heart valves. Heart (British Cardiac Society). 2019;105(18):1432-6.

89. Duan L, Doctor JN, Adams JL, et al. Comparison of direct oral anticoagulants versus warfarin in patients with atrial fibrillation and bioprosthetic heart valves. The American journal of cardiology. 2021;146:22-8.

90. Pasciolla S, Zizza LF, Le T, Wright K. Comparison of the efficacy and safety of direct oral anticoagulants and warfarin after bioprosthetic valve replacements. Clin Drug Investig. 2020;40(9):839-45.

91. Russo V, Carbone A, Attena E, et al. Clinical benefit of direct oral anticoagulants versus vitamin K antagonists in patients with atrial fibrillation and bioprosthetic heart valves. Clin Ther. 2019;41(12):2549-57.

92. Brouwer J, Nijenhuis VJ, Delewi R, et al. Aspirin with or without clopidogrel after transcatheter aortic-valve implantation. N Engl J Med. 2020;383:1447-57. doi:10.1056/NEJMoa2017815.

93. Tornos P, Sambola A, Permanyer-Miralda G, et al. Long-term outcome of surgically treated aortic regurgitation: influence of guideline adherence toward early surgery. Journal of the American College of Cardiology. 2006;47(5):1012-7.

94. Bhudia SK, McCarthy PM, Kumpati GS, et al. Improved outcomes after aortic valve surgery for chronic aortic regurgitation with severe left ventricular dysfunction. Journal of the American College of Cardiology. 2007;49(13):1465-71.

95. Fiedler AG, Bhambhani V, Laikhter E, et al. Aortic valve replacement associated with survival in severe regurgitation and low ejection fraction. Heart (British Cardiac Society). 2018;104(10):835-40.

96. Mastrobuoni S, de Kerchove L, Navarra E, et al. Long-term experience with valve-sparing reimplantation technique for the treatment of aortic aneurysm and aortic regurgitation. The Journal of thoracic and cardiovascular surgery. 2019;158(1):14-23.

97. El Khoury G, de Kerchove L. Principles of aortic valve repair. The Journal of thoracic and cardiovascular surgery. 2013;145(3 Suppl): S26-9.

98. Yacoub MH, Fagan A, Pillai R, et al. Results of a new valve conserving operation for treatment of aneurysms or acute dissection of the aortic root. Journal of the American College of Cardiology. 1983;1:708. ISSN: 0735-1097.

99. David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg. 1992 Apr;103(4):617-21; discussion 622.

100. Sarsam MA, Yacoub M. Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg. 1993;105(3):435-8.

101. Fu Y, Guidoin R, De Paulis R, et al. The Gelweave Valsalva graft to better reconstruct the anatomy of the aortic root. Journal of long-term effects of medical implants. 2016;26(2):97-121.

102. Lansac E, Di Centa I, Sleilaty G, et al. Long-term results of external aortic ring annuloplasty for aortic valve repair. European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery. 2016;50(2):350-60.

103. Urbanski PP, Zhan X, Hijazi H, et al. Valve-sparing aortic root repair without down-sizing of the annulus. The Journal of thoracic and cardiovascular surgery. 2012;143(2):294-302.

104. Hess PJ Jr, Klodell CT, Beaver TM, Martin TD. The Florida Sleeve: a new technique for aortic root remodeling with preservation of the aortic valve and sinuses. Ann. Thorac. Surg. 2005;80:2:748-50. doi:10.1016/j.athoracsur.2004.02.092.

105. Chernyavsky AM, Alsov SA, Khvan DS, et al. Comparative clinical and functional assessment of valve-preserving surgery on the aortic root during reimplantation of the aortic root into a prosthesis. Cardiology and cardiovascular surgery. 2014;7(6):54-8. (In Russ.)

106. Chernyavsky AM, Sirota DA, Alsov SA, et al. Quality of life after extravalvular prosthetics of the ascending aorta with a prosthesis with Valsalva sinuses. Pathology of blood circulation and cardiac surgery. 2012;(2):35-8. (In Russ.)

107. Arabkhani B, Mookhoek A, Di Centa I, et al. Reported outcome after valve-sparing aortic root replacement for aortic root aneurysm: a systematic review and meta-analysis. The Annals of thoracic surgery. 2015;100(3):1126-31.

108. Lee H, Cho YH, Sung K, et al. Clinical outcomes of root reimplantation and Bentall procedure: propensity score matching analysis. The Annals of thoracic surgery. 2018;106(2): 539-47.

109. Schneider U, Feldner SK, Hofmann C, et al. Two decades of experience with root remodeling and valve repair for bicuspid aortic valves. The Journal of thoracic and cardiovascular surgery. 2017;153(4):S65-s71.

110. Mazzitelli D, Pfeiffer S, Rankin JS, et al. A regulated trial of bicuspid aortic valve repair supported by geometric ring annuloplasty. The Annals of thoracic surgery. 2015;99(6):2010-6.

111. Tsai YC, Phan K, Munkholm-Larsen S, et al. Surgical left atrial appendage occlusion during cardiac surgery for patients with atrial fibrillation: a meta-analysis. European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery. 2015;47(5):847-54

112. Yao X, Gersh BJ, Holmes DR, et al. Association of surgical left atrial appendage occlusion with subsequent stroke and mortality among patients undergoing cardiac surgery. Jama. 2018;319(20):2116-26.

113. Martín Gutiérrez E, Castaño M, Gualis J, et al. Beneficial effect of left atrial appendage closure during cardiac surgery: a meta-analysis of 280585 patients. European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery. 2020;57(2):252-62.

114. Eleid MF, Nkomo VT, Pislaru SV, Gersh BJ. Valvular Heart Disease: New Concepts in Pathophysiology and Therapeutic Approaches. Annu Rev Med. 2023;74:155-70.

115. Tsurumi H, Kusunose K. Atrial fibrillation in chronic aortic regurgitation: the missing link in prognosis and surgical timing. Heart. 2025: heartjnl-2025-326727.

116. Zhang H, El-Am EA, Thaden JJ, et al. Atrial fibrillation is not an independent predictor of outcome in patients with aortic stenosis. Heart. 2020;106(4):280-6.

117. Diaz R, Hernandez-Vaquero D, Alvarez-Cabo R, et al. Long-term outcomes of mechanical versus biological aortic valve prosthesis: Systematic review and meta-analysis. The Journal of thoracic and cardiovascular surgery. 2019;158(3):706-14.e18.

118. Goldstone AB, Chiu P, Baiocchi M, et al. Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement. The New England journal of medicine. 2017;377(19):1847-57.

119. Jiang Y, Wang S, Bian J, et al. Mechanical versus Bioprosthetic Aortic Valve Replacement in Middle-Aged Adults: A Systematic Review and Meta-Analysis. J Cardiovasc Dev Dis. 2023;10(2):90. doi:10.3390/jcdd10020090.

120. Tasoudis PT, Varvoglis DN, Vitkos E, et al. Mechanical versus bioprosthetic valve for aortic valve replacement: systematic review and meta-analysis of reconstructed individual participant data. Eur J Cardiothorac Surg. 2022;62(1):ezac268. doi:10.1093/ejcts/ezac268.

121. Leviner DB, Witberg G, Levi A, et al. Mechanical vs Bioprosthetic Aortic Valve Replacement in Patients Younger Than 70 Years of Age: A Hazard Ratio Meta-analysis. Can J Cardiol. 2022;38(3):355-64. doi:10.1016/j.cjca.2021.12.008.

122. de Meester C, Gerber BL, Vancraeynest D, et al. Do guideline-based indications result in an outcome penalty for patients with severe aortic regurgitation? JACC Cardiovascular imaging. 2019;12(11 Pt 1):2126-38.

123. David TE, Ouzounian M, David CM, et al. Late results of the Ross procedure. The Journal of thoracic and cardiovascular surgery. 2019;157(1):201-8.

124. Rybka MM, Khinchagov DYa, Mumladze KV, Nikulkina ES. Protocols of anesthetic support for X-ray endovascular and diagnostic procedures performed in cardiac surgery patients of various age groups. Moscow: NMICSSX; 2018. 73 p. (In Russ.) ISBN: 978-5-7982-0385-7.

125. Landoni G, Lomivorotov VV, Nigro Neto C, et al. Volatile anesthetics versus total intravenous anesthesia for cardiac surgery. New England Journal of Medicine. 2019;380(13):1214-25.

126. Gropper MA, Miller RD, Eriksson LI, et al. (7 October 2019). Miller’s Anesthesia (9th ed.). Philadelphia, PA: Elsevier. ISBN: 978-0-323-61264-7.

127. Çelik A, Altay H, Azap A, et al. Vaccination of adults with heart failure and chronic heart conditions: Expert opinion. Turk Kardiyol Dern Ars. 2018;46(8):723-34. doi:10.5543/tkda.2018.10.5543/tkda.2018.37048.

128. Sardo S, Osawa EA, Finco G, et al. Nitric oxide in cardiac surgery: a meta-analysis of randomized controlled trials. J Cardiothorac Vasc Anesth. 2018;32(6):2512-9. doi:10.1053/j.jvca.2018.02.003.

129. Tessler J, Bordoni B. Cardiac Rehabilitation. 2022 May 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.

130. Ambrosetti M, Abreu A, Corrà U, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. European Journal of Preventive Cardiology. 2021;28:460-95. doi:10.1177/2047487320913379.

131. Butchart EG, Gohlke-Barwolf C, Antunes MJ, et al. Recommendations for the management of patients after heart valve surgery. Eur Heart J. 2005;26(22):2463-71. doi:10.1093/eurheartj/ehi426.

132. Sibilitz KL, Berg SK, Tang LH, et al. Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database Syst Rev. 2016;3:CD010876. doi:10.1002/14651858.CD010876. Update in: Cochrane Database Syst Rev. 2021;5:CD010876. doi:10.1002/14651858.CD010876

133. Sire S. Physical training and occupational rehabilitation after aortic valve replacement. Eur Heart J. 1987;8:1215-20. doi:10.1093/oxfordjournals.eurheartj.a062195.

134. Ueshima K, Kamata J, Kobayashi N, et al. Effects of exercise training after open heart surgery on quality of life and exercise tolerance in patients with mitral regurgitation or aortic regurgitation. Jpn Heart J. 2004;45(5):789-97. doi:10.1536/jhj.45.789.

135. Savage PD, Rengo JL, Menzies KE, Ades PA. Cardiac Rehabilitation after Heart Valve Surgery: Comparison with Coronary Artery Bypass Grafting Patients. J Cardiopulm Rehabil Prev. 2015;35(4):231-7. doi:10.1097/HCR.0000000000000104.

136. Gladkova MA, Kassirsky GI. Topical problems in rehabilitation following valve replacement. Cor Vasa. 1984;26:394-9.

137. Anderson L, Sharp GA, Norton RJ, et al. Home-based versus centre-based cardiac rehabilitation. Cochrane Database of Systematic Reviews. 2017;6:CD007130. doi:10.1002/14651858.CD007130.pub4.

138. Thomas RJ, Beatty AL, Beckie TM, et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140:e69-e89. doi:10.1161/CIR.0000000000000663.

139. Kraal JJ, Van den Akker-Van Marle ME, et al. Clinical and cost-effectiveness of homebased cardiac rehabilitation compared to conventional, centre-based cardiac rehabilitation: results of the FIT@Home study. Eur J Prev Cardiol. 2017;24(12):1260-73. doi:10.1177/2047487317710803.

140. Kanejima Y, Shimogai T, Kitamura M, et al. Effect of Early Mobilization on Physical Function in Patients after Cardiac Surgery: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020;17(19):7091. doi:10.3390/ijerph17197091.

141. Sahar W, Ajaz N, Haider Z, Jalal A. Effectiveness of Pre-operative Respiratory Muscle Training versus Conventional Treatment for Improving Post operative Pulmonary Health after Coronary Artery Bypass Grafting. Pak J Med Sci. 2020;36(6):1216-9.

142. Borregaard B, Dahl JS, Riber LPS, et al. Effect of early, individualised and intensified follow-up after open heart valve surgery on unplanned cardiac hospital readmissions and all-cause mortality. Int J Cardiol. 2019;289:30-6. doi:10.1016/j.ijcard.2019.02.056.

143. Thomas RJ, Balady G, Banka G, et al. 2018 ACC/AHA Clinical Performance and Quality Measures for Cardiac Rehabilitation: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. J Am Coll Cardiol. 2018;71(16):1814-37.

144. Ivanova GE, Melnikova EV, Shmonin AA, et al. Application of the international classification of functioning in the process of medical rehabilitation. Bulletin of Restorative Medicine. 2018;(6):2-77. (In Russ.)

145. Sommaruga M, Angelino E, Porta PD, et al. Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper. Monaldi Arch Chest Dis. 2018;88(2):966. doi:10.4081/monaldi.2018.966.

146. Visseren FLJ. Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227-337. doi:10.1093/eur-heartj/ehab484.

147. Ambrosetti M, Abreu A, Cornelissen V, et al. Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era. Eur J Prev Cardiol. 2021;28(5):541-57. doi:10.1093/eurjpc/zwaa080.

148. Mezzani A, Hamm LF, Jones AM, et al. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: A joint position statement of the European association for cardiovascular prevention and rehabilitation, the American association of cardiovascular and pulmonary rehabilitation and the Canadian association of cardiac rehabilitation. Eur J Prev Cardiol. 2013;20:442-67. doi:10.1177/2047487312460484.

149. Fletcher GF, Ades PA, Kligfield P, et al. Exercise Standards for Testing and Training A Scientific Statement From the American Heart Association. Circulation. 2013;128:873934. doi:10.1161/CIR.0b013e31829b5b44.

150. Opasich C, De Feo S, Pinna GD, et al. Distance walked in the 6-minute test soon after cardiac surgery: toward an efficient use in the individual patient. Chest. 2004;126(6):1796801. doi:10.1378/chest.126.6.1796.

151. Oyama J, Kudo Y, Maeda T, et al. Hyperthermia by bathing in a hot spring improves cardiovascular functions and reduces the production of inflammatory cytokines in patients with chronic heart failure. Heart Vessels. 2013;28(2):173-8. doi:10.1007/s00380-011-0220-7.

152. Knyazeva TA, Badtieva VA. Physiobalneotherapy of cardiovascular diseases. Practical guide. M. Medpress-inform, 2008. 272 p. (In Russ.) Князева Т.А., Бадтиева В.А. Физиобальнеотерапия сердечно-сосудистых заболеваний. Практическое руководство. М. Медпресс-информ, 2008. 272 с.

153. Mazzolai L, Teixido-Tura G, Lanzi S, et al.; ESC Scientific Document Group. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J. 2024;45(36):3538-700. doi:10.1093/eurheartj/ehae179.

154. Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine EANM). European Heart Journal. 2015;36(44):3075-128.

155. Engelen ET, Schutgens RE, Mauser-Bunschoten EP, et al. Antifibrino-lytic therapy for preventing oral bleeding in people on anticoagulants under going minor oral sur-gery or dental extractions. Cochrane Database Syst Rev. 2018;7:CD012293. doi:10.1002/14651858.CD012293.

156. Makuloluwa AK, Tiew S, Briggs M. Peri-operative management of ophthalmic patients on an-ti-thrombotic agents: a literature review. Eye (Lond). 2019;33:1044-59. doi:10.1038/s41433-019-0382-6.

157. Nagata N, Yasunaga H, Matsui H, et al. Therapeutic en-doscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis. Gut. 2018;67:1805-12. doi:10.1136/gutjnl-2017-313999.

158. Dohler I, Roder D, Schlesinger T, et al. Risk-adjusted perioperative bridging anticoagulation reduces bleeding complications without increasing thrombo-embolic events in general and visceral surgery. BMC Anesthesiol. 2023;23:56. doi:10.1186/s12871-023-02017-z.

159. Shah S, Nayfeh T, Hasan B, et al. Perioperative man agement of vitamin K antagonists and direct oral anticoagulants: a systematic review and meta-analysis. Chest. 2023;163:1245-57. doi:10.1016/j.chest.2022.11.032.

160. Kovacs MJ, Wells PS, Anderson DR, et al. Postopera-tive low molecular weight heparin bridging treatment for patients at high risk of arterial thrombo-embolism (PERIOP2): double blind randomised controlled trial. BMJ. 2021;373:n1205. doi:10.1136/bmj.n1205.

161. Kuo HC, Liu FL, Chen JT, et al. Thromboembolic and bleed ing risk of periprocedural bridging anticoagulation: a systematic review and meta-analysis. Clin Cardiol. 2020;43:4419. doi:10.1002/clc.23336.

162. Borer JS, Sharma A. Drug therapy for heart valve diseases. Circulation. 2015;132(11):1038-45.

163. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European Heart Journal. 2016;37(29):2315-81.

164. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica. 1983;67(6):361-70. doi:10.1111/j.16000447.1983.tb09716.x.

165. Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil. 1986;67(6):387-9.

166. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:37781.

167. Borg GA. Psychophysical scaling with applications in physical work and the perception of exertion. ScandJWorkEnvironHealth. 1990;16 (Suppl 1):55-8.


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