TAESM can be successfully performed after a history of alcohol ablation treatment. In this group, three cases had histories of alcohol septal ablation performed in the previous 6 months to 4 years. Because the drug-refractory symptoms did not disappear after ablation or recurred later, myectomy was suggested to them when they were readmitted to hospital. They had a successful surgical procedure and uneventful recovery, of whom one had MVR after a failed MVP, the other two had a significant decrease in the LVOT gradient from a preoperative level of 67–133 mmHg (with physiological provocation) to 4–10 mmHg postoperatively. Consequently, a history of alcohol ablation may not adversely affect the surgical outcome of obstructive HCM, but a higher incidence of CHB than in the case of those who underwent only surgical myectomy was observed and reported in another study [10].