Purpose. To study of the dynamics of indicators of cell perfusion of the brain according to SPECT after simultaneous surgery on the brachiocephalic and coronary arteries, study of the impact of potentially traumatic factors of surgical intervention on regional cerebral blood flow.

Material and methods. Brain perfusion data were analyzed in 22 patients with multifocal atherosclerosis who underwent simultaneous intervention in conditions of cardiopulmonary bypass on the coronary and brachiocephalic arteries. SPECT of the brain was performed with a radiopharmaceutical 99mTc-HMPAO (Ceretec).

Results. A moderate inverse correlation was found between the time of cardiopulmonary bypass, time of aortic compression, and CBF in the left occipital lobe, in the upper parts of the left frontal and left parietal lobes (R= -0,661, p=0,001), moderate direct correlation between time clamping of the carotid arteries and CBF in the region of the basal nuclei on the right and left, in the lower parts of both frontal lobes, in the upper parts of the occipital and parietal lobes (R=0,592, p=0,005). The analysis of pre and postoperative CBF revealed the following statistically significant changes: an increase in the left temporal lobe, p=0,015, a decrease in the right occipital lobe, p=0,044, a decrease in the upper part of the right parietal lobe, p=0,042, and in the upper part of the left parietal lobe, p=0,014.

Conclusion. Simultaneous surgical interventions on the brachiocephalic and coronary arteries are accompanied by a decrease in regional cerebral blood flow in the right occipital lobe and in the upper divisions of both parietal lobes, and an increase in perfusion in the left temporal lobe. Potentially traumatic factors of surgical intervention (duration of cardiopulmonary bypass, time of clamping of the aorta and carotid arteries) cause significant changes in blood flow in certain areas of the brain, which depend on the time of exposure and should be considered as risk factors for postoperative local hemodynamic disorders.