All of the following statements regarding total anomalous pulmonary connection are true except:

Answer is B (Always associated with VSD) Communication between the left and the right hea, is either ASD or a Patent Foramen Ovale. TAPVC: is an uncommon con enital cyanotic hea disease.Q Defect All pulmonary veins are connected anomolously and reach the right Atrium directly or indirectly instead of reaching the left atrium. This may occur through the following ways (Anatomic classification): Anatomical Classification : Supracardiac : Pulmonary veins join together to form a common pulmonary vein which may drain either into the left brachiocephalic vein or Superior venacava to reach Rt Atrium. Cardiac : The veins join the coronary sinus. Infracardiac : The common pulmonary veins drain into poal vein. Remember : The TAP VC of the infracardiac type is always obstructive, while cardiac and supracardiac types, may or may not have pulmonary venous obstructionQ Hemodvnamics : The blood flow to the left atrium is the Rt to Left shunt a patent foramen ovale or an ASD. Because mixing of blood occurs in Rt atrium, the oxygen saturation of blood in the pulmonary aery is identical or even higher to that in the aoa. Q Presentation : Obstructive type: presents with marked cyanosis and CHF within the first I - 2 weeks of life. Non obstructive type: presents with cyanosis and CHF but presentation is delayed to around 4 to 10 weeks of age. X-ray chest Snowman or figure of '8' configurationQ Ground glass appearance : (Characteristic of Obstructive TAP VC. Q)