Explain transposition with VSD with restricted pulmonary?

Transposition of great arteries with VSD with restricted pulmonary blood flow: Restriction to pulmonary blood flow may occur as a result of dynamic obstruction due to bulging of the interventricular septum into the LV outflow tract. Less commonly, the obstruction may be due to an obstructing sub-valvar fibrous shelf, small Pulmonary Valve annulus or abnormal mitral valve attachment to the outflow tract. These patients present with features of decreased pulmonary blood flow, similar to a neonate with Fallot's Tetralogy, with extreme cyanosis from birth.