Unmetered air or dodgy MAF would be my first point of call. I know you already looked for vacuum leaks and replaced breather hose but have you checked MAF measurements in VCDS? There are a lot of hoses by the throttle body, these can crack with age and let unmetered air in leaks are often hard to spot on them. Could also be dodgy or clogged idle control valve.
Have you tried switching AC off and see if it is better or worse?
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Currently 8less
2011 Q7 S Line 3.0TDI, 2016 Tesla Model S 90D
8 history:
2006 A8 Sport 4.2TDI quattro SOLD,
1997 S8, reached end of life with gearbox failure
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