Fluoroquinolone-Associated Type A Aortic Dissection in Alpha-1 Anti-Trypsin Deficiency

Fluroquinolone antibiotics have come under increased scrutiny given their recent association with aortic events. Although judicious use has been urged in select patient populations, such as those with Marfan and Ehlers-Danlos syndromes, that have a known predisposition for aortopathy, other at-risk patient populations may remain. We describe the atypical delayed-presentation of a type A aortic dissection in a patient with alpha-1 antitrypsin (A1AT) deficiency and longstanding FQ exposure. This case suggests that caution in prescribing fluroquinolone antibiotics should be extended to include those with A1AT deficiency. (C) 2020 by The Society of Thoracic Surgeons