During the last 20 years 156 patients underwent a direct and indirect aortic-isthmus-plastic. Early complications occurred in 7.6%. 5 patients developed an aneurysm in the area of isthmus-plastic. The mortality rare was 4.5%. There was no evidence of recurrent coarctation in a group of children and in adult patients. The indirect aortic-isthmus-plastic first described by Vosschulte represents an elegant surgical method of functionally reestablishing the aortic lumen by retaining the posterior wall for further growth potential. This technique can be performed with a low mortality rate and no recurrent coarctation of the aorta.