Total anomalous pulmonary venous return
Total anomalous pulmonary venous return
Total anomalous pulmonary venous return

The pulmonary veins do not connect to the left atrium; instead, the entire pulmonary venous return enters systemic venous circulation through various connections. Systemic blood flow depends on right-to-left atrial shunting.

AO = aorta; IVC = inferior vena cava; LA = left atrium; LV = left ventricle; PA = pulmonary artery; PV = pulmonary veins; RA = right atrium; RV = right ventricle; SVC = superior vena cava.