We have three losers in the minor suits, so we need to ruff hearts twice in dummy. However, we are short of immediate side-suit entries to hand, so we cannot ruff twice before drawing any trumps. And we may not be able to draw all the trumps first, because they will fall 3-1 half the time.
So, we must combine ruffing with using trumps as entries. Take the ♥A, ruff a heart low, cross back to hand with ♠A, ruff our last heart as high as possible (with ♠9), and return dummy's last spade so that we can draw remaining trumps from hand. Then set up a diamond trick.