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The authors describe a new surgical technique used for the repair of coarctations of the aorta with extensive segmental hypoplasia. The technique is divided into four stages: enlargement of part of the hypoplastic segment by arterioplasty, using a flap from the subclavian artery; the extent of possible enlargement is governed by the length of subclavian artery available; resection of the residual hypoplasia and of the coarctation area proper; end-to-end anastomosis of the two aortic segments; revascularization of the arm by direct implantation of the subclavian artery into the left common carotid artery.
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