Recurrent coarctation shown in this 1-year old patient who previously underwent repair by subclavian flap aortoplasty. The white arrow demonstrates the absent left subclavian artery, while the black arrow demonstrates the recurrent coarctation. Balloon angioplasty successfully reduced the gradient across the obstruction from 80 mmHg to 15mmHg. This patient further has a common origin of the left carotid artery and the innominate artery, a common aortic arch variant.