A 34-year-old male patient was admitted to our hospital with sudden onset of severe chest pain. A diagnosis of acute aortic dissection (Stanford type A) was made based on the results of examinations such as CT-scan and angiography. An emergency surgical replacemant of the ascending aorta was carried out. Multiple malperfusion phenomena such as cerebral, renal, right upper extremity and visceral Ischemia appeared postoperatively. With strict conservative therapy and laparotomy (descending colectomy), he survived and was rehabilitated. Acute aortic dissection associated with malperfusion phenomena are frequent and potentially extremely poor complication. Therefore, prognosis is determined by accurate and rapid diagnosis and salvage of the ischemic organs. In treatment of the acute aortic dissection, the control of the blood pressure is important, but also close attention should be paid to sufficient perfusion of the major organs.