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Microbiological and morphological methods were used to study abnormalities in the greater microcirculation in acyanotic heart disease. The bulbar conjunctiva (patients), greater omentum and cardiac serous membranes (autopsy material) were used as test objects. The most marked changes were revealed in the metabolic link of the microcirculatory system. They were characterized by progressive reduction in intrinsic capillaries and an increase in the modulus of microcirculation of microvessels (capillaries) of the great (exchange-shunting) type. The alternations in the structure of the microcirculatory system were accompanied by centralization of tissue blood flow and its decreased metabolic efficiency, which were clinically manifested by tissue capillary trophic tissue failure with the occurrence of a number of severe common symptoms of the disease and various organ lesions in children. Analyzing the results of the study enabled the author to be the first to reveal in the above cardiac pathology specific tissue blood circulatory disorders which are interpreted as a phenomenon of centralized microhemodynamics. The important results of the study is also the morphofunctional rationale for the concept "capillary trophic incompetence".