SERPINA1 and alpha 1-antitrypsin deficiency: Guzzardi et al. (44, 45) published a report suggesting that patients with alpha-1 antitrypsin (A1AT) deficiency and longstanding FQ use (26 months) may have a higher risk of AAD, although patients with A1AT deficiency are not typically considered at risk of aortopathy despite maladaptive connective tissue changes.