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Pulmonary atresia may occur with a normal or an abnormal aortic root; in either case the presence of a collateral circulation to the lungs is obligatory for survival. This may be via a patent ductus arteriosus, if the main branches of the pulmonary artery are developed, by enlarged bronchial arteries anastomosing with the pulmonary artery branches or supplying the lungs direct, or by means of some other systemic pulmonary anastomosis from the aorta or great vessels.

Pulmonary atresia with bronchial arteries arising from the subclavian arteries.