Optimizing Myocardial Protection in Minimally Invasive Cardiac Surgeries: A Network Comparison of Del Nido, Histidine-Tryptophan-Ketoglutarate, and Blood Cardioplegia.

: The optimal choice of cardioplegia solution in minimally invasive cardiac surgeries (MICS) remains debated, as prolonged myocardial protection is essential to avoid interruptions to the surgical flow, which can prolong aortic cross-clamp time and cardiopulmonary bypass time, especially in the constrained surgical field. We conducted a network meta-analysis to evaluate the safety and efficacy of the del Nido (DN), histidine-tryptophan-ketoglutarate (HTK), blood cardioplegia (BC), and St. Thomas' (STH) solutions in MICS.