There is the consensus that patients with an acute type A aortic dissection (AADA) should undergo urgent surgical treatment. However, we dared to select a two-staged repair in order to relieve the visceral ischemia first. In addition, we selected revascularization using a bypass graft without using a proximal aortic replacement or aortic fenestration, because the reason for the occlusion of the SMA was judged to be an extension of the dissection out along the proximal segment of the SMA. Consequently, we proposed that a two-staged repair of the AADA with visceral ischemia was a useful option.