Background: Coarctation of aorta was seen in 7% at congenital heart disease and a critical neonatal Coarctation is a severe juxta ducal constriction of aorta which results in profound circulatory collapse in first month of life.
Left subclavian artery flap procedure have been described by meier and De Medowa.

Methods : This study was done in 32 patients with critical coarctation of aorta with severe congestive heart failure and under went left aortopalsty of coarctation of aorta between 1995 until 2008 in chamran open heart hospital (Isfahan).
The mean age was 6.4 1/2 months, the mean weight was 5.5 0/8 kg and in 10 cases were seen large PDA and 3 case with as and VSD in 2 cases.

Results: There were two case hospital deaths (6.3%) and we did not see late death. All patients were follow- up with Echocardiography and 90% were free from significant gradient (under 20 mmHg). All patients were free from wound infection and hand Ischemia.
At a mean follow up was 2 years and the mean ICU stay was 2 day.

Conclusion: Left subclavian flap aortoplasty in repair of critical coarctation of aorta may have favorable effects in development aorta and was safe. Fast and with low mortality and morbidity and rate of recoarctation.
In our study was zero percent.