OBJECTIVES: We have recently shown that continuous coronary perfusion with warm blood enriched with the ultra-short acting ß-blocker Esmolol (ES) improves functional and structural myocardial protection during coronary artery bypass grafting (CABG) as compared with conventional cardioplegia (CP). The purpose of the present study was to compare both myocardial protection techniques in terms of patient outcome and economical aspects. METHODS: We retrospectively analyzed the charts of 150 consecutive patients who received CABG using the ES-technique; 150 patients matched for age, gender, preoperative left ventricular function, history of renal failure, and history of neurological symptoms who underwent CABG using the conventional CP-technique served as control group. RESULTS: There were no significant differences between both groups with respect to perioperative myocardial infarction rate, need for positive inotropic medication, need for mechanical circulatory support, duration of mechanical ventilation, duration of intensive care unit stay, time of mobilization, postoperative renal failure, cardiac arrhythmia’s, neurological symptoms, infections as well as in-hospital mortality. However, ES-patients were less frequently re-admitted to the intensive care unit (ES: 3/150 (2%) vs. CP: 13/150 (9%); p=0.015) and earlier discharged from the hospital (ES: 12.3±4.8 days vs. CP: 13.5±3.8 days; p=0.009). In addition, the ES-technique itself was more economical (drug costs for ES-technique: about DM 120 per patient vs. CP-technique: about DM 260 per patient). CONCLUSIONS: Our data suggest that improved myocardial protection during CABG using the ES-technique may be a cost-saving alternative to the conventional CP-technique due to both shorter hospital stay and lower procedural costs.