The changes of children myocardium lipid composition were studied for the first time during surgical intervention under cold crystalloid cardioplegia. The surgical intervention was performed as a result of congenital heart disease--atrial septal defect. It was shown that the quantity of short chain fatty acids decreased and the amount of long chain fatty acids increased in the content of phospholipid fraction. Simultaneously the amount of linoleic (C18:2 omega 6), of docosahexaenoic (C22:6 omega 3) and of some other fatty acids decreased in the content of cholesterol esthers. The accumulation of free linoleic (C18:2 omega:6), (C18:2 omega:4) and linolenic (C18:3 omega:6) acids was found. Reperfusion caused the additional changes of myocardium lipid composition. The amount of palmitic (C16:0) acid decreased by 30%. The quantity of some other saturated free fatty acids also diminished. Simultaneously the content of free oleic (C18:1 omega 9) also decreased as a consequence of lipid peroxidative processes activation. The ratio of omega 6/omega 3 increased during the few first minutes of reperfusion in the fraction of free fatty acids and cholesterol esthers.