Aim. To evaluate early and long-term (over 20 years) results of surgical treatment of isolated aortic valve disease. Material and methods. 516 patients underwent heart valve replacement for the period 1995—2016. 366 mechanical prostheses (MP) (MedEng-2, n=194; MICS, n=109; Carbomedics Orbis, n=31; Medtronic-Hall, n=15; St.Jude Medical, n=14; Carbomedics Standart, n=3), and 150 bioprostheses (BP) (UniLine, n=135; AB Mono Composite, n=8; Medtronic Freestyle, n=5; Tiara, n=2) were implanted. The volume of follow-up period was 2715.8 patient-years. The mean age of patients was 53.5±9.5 years. Results. In-hospital mortality was 3.47% (n=14). The linearized rate of mortality in the long term period for BP recipients was 0.41% patient-years and for MP recipients — 2.94% patient-years. 15-year actuarial survival rates were 84 and 92.8% in MP and BP groups, respectively. Thromboembolism and clinically relevant bleeding were observed only among MP recipients. The linearized and actuarial rates of bleeding and embolism were 0.44 and 0.99%/patient per year and 97.4 and 94.6% in 20 years after surgery, respectively. Linearized and actuarial rates of redo procedures in BP and MP groups were 0.15 and 0.48 and 99.2 and 97.3% in 15 years after surgery, respectively. In-hospital mortality after redo procedures in BP recipients was 5.9% (n=1) and in MP recipients — 17.6% (n=3). The correlation analysis revealed an inverse relationship between left ventricular mass index and survival (r=–0,731) and arterial hypertension in the long-term period (r=–0,622). Conclusion. Biological valve implantation for isolated aortic valve defect improves long-term survival. Patients with acquired heart disease and initial hemodynamic derangements should receive preventive antibiotic therapy. Untreated arterial hypertension significantly worsens long-term survival after aortic valve replacement.