Selecting the optimal treatment for transposition of the great arteries with pulmonary stenosis is a challenge. The Rastelli procedure has long been the method of choice, but it carries the risk of subaortic obstruction. The dysplastic pulmonary valve, which cannot function under systemic pressure, can sometimes be recycled in the pulmonary position. "En bloc" rotation of the outflow tracts has been proposed for treatment of complex transposition of the great arteries and is demonstrated in the following videos. It is a technically demanding procedure and in this tutorial we provide a step-by-step presentation of its technique and the surgical options.