Ventriculo-coronary communication is frequently encountered in pulmonary atresia patients who have an intact ventricular septum. Preoperative documentation is important to decide the feasibility of right ventricular decompression procedure. Experience of Doppler echocardiographic visualization of this anomaly in a case of critical pulmonary stenosis with intact ventricular septum is reported. Doppler echocardiography is a promising method of detection and should be used in every patient with a high-pressured hypoplastic ventricle before intervention.