Hemi-Nikaidoh: Partial Aortic Root Translocation and Posterior Left Ventricular Outflow Tract Plasty

Among repairs for ventriculoarterial discordance, ventricular septal defect, and pulmonary stenosis, aortic root translocation (Nikaidoh operation) offers the most anatomic result. With a diminutive pulmonary annulus or hypoplastic left ventricular outflow tract, the distance gained posteriorly with aortic translocation is negligible. We developed the "hemi-Nikaidoh" procedure as an alternative. Geometric shift is achieved by mobilizing the anterior two-thirds of the aortic root, and posterior aortic translocation is performed by plicating the left ventricular outflow tract without dividing the conus. The right ventricular outflow tract is reconstructed with an orthotopic conduit. Herein, we describe the hemi-Nikaidoh operation.