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Several studies reported the safety and potential benefits of single-dose Del Nido cardioplegia (DNC) in selected adult cardiac surgery (ACS) procedures. However, studies are scarce on routine use of DNC in more complex procedures and patients with a high risk profile. We sought to compare DNC with cold blood cardioplegia (BC) in all types of ACS including complex procedures. Data for 305 consecutive unselected patients who underwent ACS procedures (July/2017 to November/2019) were included. DNC was routinely used whenever is available (