This retrospective single-center study compared four cardioplegia strategies in 543 patients undergoing minimally invasive aortic valve replacement from 2010 to 2025. After inverse probability weighting balanced baseline differences, Calafiore and Custodiol were associated with less postoperative atrial fibrillation, lower CK/CK-MB release, and fewer respiratory complications than Buckberg, while mortality, stroke, ICU stay, hospital stay, and postoperative LVEF were similar.