TNF and rheumatic heart disease: This study aimed to evaluate the effects of dexmedetomidine (DEX) in patients undergoing valve replacement surgery for rheumatic heart disease (RHD), focusing on its impact on serum levels of inflammatory markers (IL-8, IL-10, TNF-a) and myocardial injury markers (Cardiac Troponin I [cTnI], Creatine Kinase-MB [CK-MB]).