Prostaglandin E1 infusion and a microporous expanded polytetrafluoroethylene graft were used in the management of eight infants, all less than 4 days old, with interruption of the aortic arch. Five of the six infants receiving prostaglandin E1 responded dramatically to this therapy, with return of lower limb pulses and lessening of metabolic acidosis. There were no adverse effects attributable to the prostaglandin E1 infusion. Seven infants subsequently underwent aortic reconstruction with a polytetrafluoroethylene graft. There were no operative deaths, and in up to 3 years of follow-up of these patients, graft obstruction occurred in only one patient and this graft was successfully revised. The long-term mortality rate was high (62 percent); all deaths but one were attributable either to the palliation or to the total correction of the associated cardiac malformations.