Objectives:Surgical management of aortic arch hypoplasia with associated intra-cardiac anomalies is a challenge in newborns.We reviewed the characteristics and outcomes of neonates and infants who underwent pulmonary artery banding concomitant to arch repair and single-stage total repair at our institution. Methods:Medical records of 60 patients undergoing aortic arch reconstruction for aortic arch hypoplasia between 2014 to 2019 were retrospectively reviewed.Twenty-five patients were female (41.6%), and the age of the patients ranged from 4 to 120 days (median 19.5 days).The patients were divided into two groups;Group 1 (23 patients) underwent pulmonary artery banding concomitant to arch repair, Group 2 (37 patients) underwent single-stage total repair in addition to arch repair.All arch repair procedures consisted of an extended (to the midportion of the ascending aorta)patch aortoplasty. Results:Postoperative early mortality occurred in 12 patients, 8 in Group 1(34.8%), and 4 in Group 2 (10.8%).There was an early survival advantage in group 2 (p=0.019).Recoarctation was occurred in 13 cases (21.6%), and 11 (18.3%) of them required reintervention (balloon angioplasty:7, re-operation:4).On univariate analysis, risk factors associated with death were pulmonary artery banding (HR,0.44;CI,0.09-2;p=0.019),prematurity (HR,4,67;CI,1.34-16.18;p=<0.001),preoperative mechanical ventilation support requirement (HR,0.048;CI, 0.52-6.39;p=0.048),and functional single ventricle (HR,0.43;CI,0.1-1.86;p=0.006).The mean duration of follow-up was 21.9±15.1 months, and there was no late death in each group. Conclusion:Single-stage repair of aortic arch hypoplasia with intracardiac pathologies has better results than palliation, according to survival rates and postoperative results.The use of patch augmentation technique in aortic arch hypoplasia is valid and associated with an acceptable incidence of recurrent arch obstruction.