An area of previous infarct is visible in the mid septum. The myocardium is thinned and akinetic. This patient had an initial good response to alcohol ablation before a deterioration in symptoms and gradients at 6 months. The anterior leaflet of the MV now bends back to contact the viable myocardium in the extreme basal septum. She returned for repeat ASA. View Video 3 at http://movie-usa.glencoesoftware.com/video/10.1530/ERP-15-0002/video-3.