Which congenital anomaly is most commonly associated with Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White (WPW) syndrome is characterized by the presence of an accessory conduction pathway in the heart, which can lead to episodes of tachycardia due to re-entrant circuits. One congenital anomaly that is notably associated with WPW syndrome is Ebstein's anomaly.

Ebstein's anomaly involves a malformation of the tricuspid valve that allows for the presence of an accessory pathway and is often associated with arrhythmias, including those seen in WPW syndrome. Patients with Ebstein's anomaly may have a displaced tricuspid valve, leading to atrial enlargement and electrical conduction anomalies, which can manifest as WPW.

The other options, while they represent significant congenital heart defects, do not have as clear an established connection with WPW as Ebstein's anomaly does. Ventricular septal defects, tricuspid atresia, and patent ductus arteriosus can occur independently of WPW and do not have a recognized association with the abnormal conduction pathways seen in this syndrome. This makes Ebstein's anomaly the most commonly associated congenital heart defect with Wolff-Parkinson-White syndrome.