This propensity score-matched, single-center study compared Custodiol and Del Nido cardioplegia in 778 patients undergoing minimally invasive mitral valve repair. Del Nido was linked to lower postoperative CK and CK-MB release, less need for cardioversion after declamping, fewer shocks, higher perioperative sodium, and lower early inotrope use. Major complications, length of stay, and 30-day mortality were similar, suggesting better myocardial protection with Del Nido.