Two patients with left ventricular and proximal aortic hypertension secondary to diffuse hypoplasia of the aortic arch have recently been treated by a surgical technique based on: I simultaneous exposure of the ascending and descending thoracic aorta through a left antero-latero-posterior thoracotomy; 2 insertion of a Dacron graft between the aortic root and the descending thoracic aorta. In both cases equal systemic pressures in the ascending and descending thoracic aorta and adequate distal perfusion were obtained.