biostudies-literatureUnknown31(1)Sato RSeptal reduction therapy is an effective treatment for hypertrophic obstructive cardiomyopathy (HOCM). Alcohol septal ablation (ASA) is indicated for HOCM patients who are ineligible for surgical myectomy, but several tips exist for the management of high-risk patients with ASA. Here, we present a case of successful ASA in a HOCM patient with multiple comorbidities, including severe obesity, drug-refractory bronchial asthma, poorly controlled diabetes, and steroid-induced immunosuppression. Pre-procedural strict glycemic control, pre-treatment with corticosteroids for bronchospasm prevention, minimal puncture sites for device insertion, and myocardial contrast echocardiography-guided procedure contributed to the achievement of successful ASA. With careful periprocedural management, ASA is Journal of cardiology cases5-8https://www.ebi.ac.uk/biostudies/studies/S-EPMC11745786biostudies-literatureAlcohol septal ablation in drug-refractory hypertrophic obstructive cardiomyopathy patient with multiple comorbidities.PMC11745786Sano MTsukui HSatoh TSato RSakamoto AIkoma TIguchi KMaekawa YSuwa KAkita KfalseAlcohol septal ablation in drug-refractory hypertrophic obstructive cardiomyopathy patient with multiple comorbidities.Septal reduction therapy is an effective treatment for hypertrophic obstructive cardiomyopathy (HOCM). Alcohol septal ablation (ASA) is indicated for HOCM patients who are ineligible for surgical myectomy, but several tips exist for the management of high-risk patients with ASA. Here, we present a case of successful ASA in a HOCM patient with multiple comorbidities, including severe obesity, drug-refractory bronchial asthma, poorly controlled diabetes, and steroid-induced immunosuppression. Pre-procedural strict glycemic control, pre-treatment with corticosteroids for bronchospasm prevention, minimal puncture sites for device insertion, and myocardial contrast echocardiography-guided procedure contributed to the achievement of successful ASA. With careful periprocedural management, ASA is 2025-01-01T00:00:00Z2025 Jan2025-04-03T23:58:07.223Z2025-04-03T23:58:07.223ZS-EPMC117457863983973610.1016/j.jccase.2024.09.003