Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: the perfect septal branch may originate from an atypical location.

Due to anatomical variability in the distribution and size of septal perforator arteries, not all patients are ideal candidates for alcohol septal ablation. Myocardial contrast echocardiography is essential in selecting the appropriate septal branch. We report a case where the target septal artery did not originate from the left anterior descending artery, but from the first diagonal branch.