[Evaluation of the status of the myocardium during surgical correction of congenital heart defects by simultaneous study of ultrastructure and macroergic phosphates (in biopsies of the human heart)].

During surgical correction of Fallot's tetrad the authors discovered the decrease of macroergic phosphate concentration and moderately marked signs of cardiomyocytic ultrastructural changes, such as mitochondrial injuries, decrease of glycogen levels, insignificant intracellular edema, no increase of membrane penetration. Changes of endothelial cells were absent. In children not over 1 year old under myocardial protection with hypothermic perfusion (at low volume rates) some decrease of macroergic phosphates occurred, as well as a moderate decrease of the mitochondrial index, glycogen content decrease, there was no intracellular edema. The discovered structural changes are minimal and reversible. A close correlation was found between the electron microscopic data and the character of myocardial energetic metabolism, the biochemical changes preceding the ultrastructural ones. Comparison of morpho- and biochemical changes in the myocardium of the majority of patients with impaired myocardial function confirmed the existence of a complex relationship between them.