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We describe a case of pulmonary artery band placement in a 2-month-old infant with dilated cardiomyopathy and moderate mitral regurgitation in impending need of ventricular assist device. Despite minimal change in echocardiographic appearance, pulmonary artery band placement resulted in significantly reduced left atrial pressure and unchanged right atrial pressure. Improved cardiac output has enabled weaning from ventilator support and favorable somatic growth with enteral feeding. The patient has been stable on milrinone for 3 months, awaiting cardiac transplantation on a regular ward. This therapy represents a potential alternative in small children, who are deemed high-risk candidates for mechanical circulatory support. [ABSTRACT FROM AUTHOR]