A 9-year-old boy whose past history was remarkable for a heart murmur was diagnosed with abdominal angina due to acute occlusion of a simple coarctation of the aorta. Using a single cross-clamp, we accomplished an end-to-end anastomosis after resection of the coarctation. Paradoxical hypertension and abdominal angina were treated successfully with a continuous intravenous infusion of lipo-PGE-1 and nicardipine. Three years after his operation, the patient's blood pressure was normal, with no stenosis at the site of the anastmosis.