We performed histoenzymological and electron-microscopic investigations of 40 myocardial biopsies taken during open heart surgery under extracorporeal circulation (ECC) from patients with valvular cardiopathies and septal interatrial defects with various degrees of congestive cardiac insufficiency (CCI). The changes occurring in the topochemistry and intensity of the enzymatic reactions used as markers for mitochondria, namely SDH and LDH, demonstrated the existence of a correlation between the decrease of reactions of the CCI degree. The ultrastructural aspects of the mitochondrial changes attested the precocity and severity of damage in these organelles even from initial moments of hypoxia.