Retrograde coronary sinus perfusion as a means of delivering cardioplegia was evaluated in 20 patients undergoing cardiac valve surgery. Other 10 patients, undergoing similar operation with antegrade coronary cardioplegic perfusion served as a control. Results showed no significant differences between the two groups of patients in terms of: myocardial cooling; pre-ischemic and post-perfusion myocardial lactate extraction; post-operative clinical findings (myocardial infarction occurrence, need for inotropic support, mortality). We conclude that retroperfusion through the coronary sinus is a safe and effective alternative of cardioplegic delivery. Since it simplifies the operative procedure (it allows the cardioplegia delivery at any desired time of the operation, without discontinuing the procedure), we recommended its use during valvular cardiac operations, especially on aortic valve replacement.