We report an emergent complex hybrid repair of a type A Intramural
Hematoma with a tear of the aortic arch at the site of Kommerell's
Diverticulum and an Aberrant Right Subclavian Artery. We identified a
type Ia endoleak intraoperatively, which was managed immediately with
proximal extension. Performing this operation in the hybrid operating
room facilitated optimal surgical management.