The italicized title, The Tangled Ties That Bind: is in italics because it is a literary title and should be transcribed as an italicized passage. It is followed by a colon, which means "there's more," which appears to be a subtitle or series name. If this is a centered heading, each line would be a separate text element. Italics are ignored for a centered title. You could use the italics symbol indicator for the "A" if it actually requires emphasis.
Braille Formats 5.3.1 says "Print font attributes may be ignored when they are used for decorative purposes and do not add information for the reader."
But if your example is embedded in a sentence, it should follow print. An italics passage would be used for the title. But what information is the reader getting from the italicized "A" —which is an indefinite article that doesn't appear to require emphasis or distinction.? Not seeing your original text, I am wondering if the A might just be there for visual appeal.
If there is a significant reason for the A in italics, I would terminate the italics passage after the colon and use the italics symbol indicator before A for better readability.