The figure shows the major issues of Nikaidoh's procedure. Figure 10A shows the areas for harvesting the aortic root and transection of the pulmonary trunk. In 10B, the aorta and pulmonary trunk have already been disconnected from their previous insertion, and the line of division of the outlet septum is shown. Figures 10C and 10D show aortic translocation and reconstruction of the left outflow tract, with a pericardial patch used to close the ventricular septal defect. In 10E and 10F, the pulmonary trunk is sutured to the right ventricular outflow tract, and the reconstruction is completed with a pericardial patch. (adapted from . Martins P, Tran V, Price G, Tsang V and Cook A, Cardiol Young 2008; 18:124–34, with permission from Cambridge University Press).