All of the following are true regarding Tetralogy of Fallot except

The four components of the tetralogy of Fallot are malaligned VSD, obstruction to RV outflow, aoic override of the VSD, and RV hyperophy due to the RV's response to aoic pressure the large VSD When the RV outflow obstruction is severe, pulmonary blood flow is reduced markedly, and a large volume of desaturated systemic venous blood shunts right-to-left across the VSD. ( Harrison&;s principle of internal medicine,18th edition,pg no. 1927)