We present a hybrid surgical and endovascular repair for type A aortic dissection complicated with visceral ischemia. The patient had a history of coronary artery bypass grafting using the right gastroepiploic artery bypassed to the left anterior descending artery. Because of exacerbated metabolic acidosis and coronary ischemia caused by insufficient blood flow of the celiac artery and the superior mesenteric artery, the percutaneous transluminal angioplasty for both arteries was performed before surgical central repair. Hybrid operating room settings and equipment are considered to be a feasible option for treating patients with type A aortic dissection complicated with vital organ malperfusion.