Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: monopril / lipitor / simvastatin / crestor / zetia / niacin attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: minimal invasive mitral valve replacement history of present illness: 63 year old male with history of valvular heart disease and pulmonary embolus and dvt in . he describes slowly worsening symptoms of dyspnea on exertion that was first noted one year ago. he underwent an echocardiogram on which revealed severe mitral regurgitation, left atrial enlargement and pulmonary hypertension. mitral regurgitation has progressed from + in to + on this most recent echo. he also underwent tee which also revealed severe mr with significant p2 prolapse with flail leaflet tip. he is referred for surgical evaluation. past medical history: mitral regurgitation pulmonary hypertension pulmonary embolus and deep vein thrombosis (? protein deficiency- hypercoaguable risk on pre-op coumadin) hyperlipidemia hypertension obesity psoriasis varicose veins phlebitis 25 yrs ago s/p tonsillectomy s/p appendectomy social history: race: caucasian last dental exam: wks ago lives with: husband occupation: retired engineer tobacco: former tobacco use (none since college) etoh: occ. family history: non-contributory physical exam: pulse: 72 resp: 16 o2 sat: 99% b/p right: 133/88 left: 139/89 height: 5'8" weight: 197 lbs general: well-developed male in no acute distress skin: dry intact psoriatic lesions on ble heent: ncat perrla eomi neck: supple full rom jvd chest: lungs clear bilaterally heart: rrr irregular murmur 4/6 systolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema rle 1+ varicosities: r>l greatest at right upper calf neuro: grossly intact pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit right: - left: trans pertinent results: echo: prebypass: the left atrium is moderately dilated. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size is normal with normal free wall contractility. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is prolapse of the p2 mitral leaflet. the mitral valve leaflets do not fully coapt. moderate to severe (3+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet (directed anteriorly), its severity may be significantly underestimated (coanda effect). there is no pericardial effusion. postbypass: the patient is on infusions of norepinephrine and milrinone and transiently epinephrine. there is a new bioprosthetic mitral valve. it is well seated without evidence of paravalvular leak. gradients across the valve are peak/mean of 17/7 mmhg. right ventricular function, initially moderately depressed immediately postbypass, has now improved to normal. left ventricular systolic function continues to be normal. normal thoracic aorta. 04:55am blood wbc-6.7 rbc-3.50* hgb-10.8* hct-30.6* mcv-87 mch-30.8 mchc-35.3* rdw-14.1 plt ct-93* 04:55am blood glucose-130* urean-20 creat-0.7 na-138 k-3.8 cl-103 hco3-28 angap-11 04:55am blood mg-2.3 03:45pm blood %hba1c-5.6 eag-114 brief hospital course: was admitted the day before surgery for a heparin bridge. on he underwent a minimally invasive mvr (porcine). this procedure was performed by dr. , please see the operative note for details. he tolerated this procedure well and was tranfered in critical but stable condition to the surgical intensive care unit. he quickly extubated. his chest tubes were removed and he was tranferred to the surgical step down floor. he was seen by the physical therapy service. by post-operative day #3 he was ready for discharge to home with vna. all follow-up appointments were advised. first blood draw/inr check monday with results to dr. . target inr 2.0-2.5. medications on admission: coumadin 4 mg daily->***last dose taken folic acid 1 mg daily hctz 12.5mg daily cozaar 25mg daily k-dur 10 meq daily lorazepam 0.5 mg prn->rarely uses discharge medications: 1. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 10 days. disp:*20 tab sust.rel. particle/crystal(s)* refills:*1* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 weeks. disp:*28 tablet(s)* refills:*0* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 5. warfarin 2 mg tablet sig: two (2) tablet po once (once) for 3 days: 4 mg dose today, sat, and sunday; then all further daily dosing by dr. . disp:*50 tablet(s)* refills:*0* 6. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). disp:*45 tablet(s)* refills:*1* 7. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. disp:*20 tablet(s)* refills:*1* 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 9. ibuprofen 600 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 1 months: take with meals. disp:*90 tablet(s)* refills:*0* 10. fluocinonide 0.05 % cream sig: one (1) appl topical (2 times a day). disp:*2 tubes* refills:*0* 11. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*1* 12. outpatient lab work inr goal for pe/dvt/protein factor deficiency/tissue valve is 2-2.5 first inr draw will be on monday with results faxed to the office of dr. (, phone ( discharge disposition: home with service facility: tba discharge diagnosis: mitral regurgitation s/p minimal invasive mitral valve replacement past medical history: pulmonary hypertension pulmonary embolus and deep vein thrombosis ( ? protein deficiency-hypercoaguable risk/pre-op coumadin) hyperlipidemia hypertension obesity psoriasis varicose veins phlebitis 25 yrs ago s/p tonsillectomy s/p appendectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** first inr blood draw monday with results to dr. , all further daily dosing of coumadin by dr. target inr 2.0-2.5 followup instructions: you are scheduled for the following appointments surgeon: dr. on at 1:30pm cardiologist: dr. on at 12pm please call to schedule appointments with your primary care dr. in weeks hematologist dr. . in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** inr goal for pe/dvt/protein factor deficiency/tissue valve is 2-2.5 first inr draw will be on monday with results faxed to the office of dr. (, phone ( procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft diagnoses: mitral valve disorders unspecified essential hypertension other chronic pulmonary heart diseases other and unspecified hyperlipidemia personal history of venous thrombosis and embolism primary hypercoagulable state obesity, unspecified other psoriasis asymptomatic varicose veins 

Answer: The patient is high likely exposed to