We present a case of an aortic atresia and a persistent right aortic arch with a retro-aortic brachiocephalic vein. A left neo-aortic arch was constructed using a reversed subclavian flap and a standard Norwood-type patch enlargement to provide systemic outflow. The intercarotid section of the aortic arch was hypoplastic. Therefore, we maintained the patency of the right arch, thus creating a vascular ring.