Operative data.

This study aimed to evaluate the safety and efficacy of a modified, bloodless Del Nido (DN) cardioplegia solution in patients undergoing isolated aortic valve replacement (AVR). A total of 370 patients who underwent isolated AVR between 2015 and 2022 were retrospectively analyzed. Patients were categorized into two groups based on the cardioplegia solution used: the bloodless DN group (N = 180) and the histidine-tryptophan-ketoglutarate (HTK) group (N = 190). To reduce selection bias and adjust for baseline differences, inverse probability of treatment weighting analysis was performed. There was no significant difference in in-hospital mortality between the two groups (HTK vs. DN: 1.2% vs. 0.9%, P = 0.554). However, the rate of spontaneous sinus rhythm restoration without the need for defibrillation following aortic cross-clamp release was significantly higher in the DN group (40.0% vs. 75.2%, P