In a newborn with a large ventricular septal defect who has undergone pulmonary artery banding, which assessment best indicates the band is functioning effectively?

In a newborn with a large ventricular septal defect who has undergone pulmonary artery banding, which assessment best indicates the band is functioning effectively?

• A. Capillary refill less than 3 seconds
• B. Urine output greater than 1 mL/kg/hr
• C. Breath sounds clear and equal bilaterally
• D. Radial pulses are bounding

Answer: (C)

After pulmonary artery banding, the goal is to limit pulmonary blood flow enough to prevent lung congestion while maintaining adequate systemic circulation. The clearest, most direct sign that the band is doing its job is that the lungs are not congested—breath sounds are clear and equal on both sides. This reflects reduced pulmonary overcirculation and absence of pulmonary edema, indicating the band is restricting flow to the lungs as intended. Capillary refill and urine output are useful indicators of overall perfusion but don’t specifically show whether the banded pulmonary flow is at the appropriate level. Bounding radial pulses don’t directly tell you about the balance between pulmonary and systemic circulation and could point to other issues.

After pulmonary artery banding, the goal is to limit pulmonary blood flow enough to prevent lung congestion while maintaining adequate systemic circulation. The clearest, most direct sign that the band is doing its job is that the lungs are not congested—breath sounds are clear and equal on both sides. This reflects reduced pulmonary overcirculation and absence of pulmonary edema, indicating the band is restricting flow to the lungs as intended.

Capillary refill and urine output are useful indicators of overall perfusion but don’t specifically show whether the banded pulmonary flow is at the appropriate level. Bounding radial pulses don’t directly tell you about the balance between pulmonary and systemic circulation and could point to other issues.