Inflammation related cardiac complications of heart surgery

The local and systemic inflammatory response that occurs after cardiac surgery is an important contributor to the risk of several postoperative cardiac complications. Dexamethasone is a potent inhibitor of the postoperative inflammatory cascade and might be useful for the prevention of these complications. In this thesis, we investigated the effects of dexamethasone prophylaxis on the incidence of post pericardiotomy syndrome, postoperative atrial fibrillation, reoperations and the extent of myocardial injury. Dexamethasone was not able to reduce the incidence of these complications and had no effect on the extent of myocardial injury. However, the use of dexamethasone was associated with an increased rethoracotomy risk. We conclude that the etiology of these complications is multifactorial and that inflammation is likely to play an important role, but only in a part of the patients. Future research should therefore focus on identifying patients in whom inflammation is indeed the main cause of these complications.