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: sulfa (sulfonamide antibiotics) attending: chief complaint: chest pain/dyspnea major surgical or invasive procedure: aortic stenosis s/p redo-sterntomy, aortic valve replacement history of present illness: 83 year old gentleman with history of coronary artery disease status post cabg in followed by two drug eluting stents to the left anterior descending artery in who has known aortic stenosis followed by serial echocardiograms. over one month ago he was admitted for further work-up for chest pain. workup revealed native three vessel coronary artery disease with essentially patent vein grafts however his aortic stenosis was found to be significantly worse by catheterization. an echocardiogram showed moderate aortic stenosis, severe mitral regurgitation and moderate tricuspid regurgitation. he continues to be symptomatic with occasional chest tightness, dyspnea on exertion and worsening fatigue. given the severity of his disease and new onset of symptoms, he was seen and accepted by dr for surgical revascularization and valve replacement. however pt was noted to have slow gi bleeding and he underwent extensive work-up to evaluate source prior to surgery. colonoscopy and two endoscopies were negative for any significant findings. his coumadim and aspirin have been on hold for over a month. he was cleared for surgery and is being admitted today to the cardiac surgery service for his surgery tomorrow. past medical history: - ptca with des to lad x2 in - atrial fibrillation - hypertension - hyperlipidemia - bph - pud nonbleeding - ventricular ectopy - cataracts - gastric lymphoma - b-12 deficiency - squamous cell cancer left ear - h/o gi bleed (transfused 2 units) - h/o peptic ulcer past surgical history: - coronary artery bypass graft x 2: , svg-lad, svg to rca - gastric lymphoma s/p partial gastrectomy with occ dumping syndrome - s/p left parathyroidectomy - s/p partial gastrectomy social history: race: caucasian last dental exam: lives with: wife in occupation: shellfish farmer. active with boating and fishing. cigarettes: smoked no yes last cigarette _____ hx: other tobacco use: etoh: drink/week drinks/week >8 drinks/week illicit drug use family history: father with fatal mi at 62, grandfather with mi in 60s. no family history of arrhythmia, cardiomyopathies, or sudden cardiac death; mother had cad and died in her early 70's. physical exam: pulse: 72 af resp: 16 o2 sat: 98% b/p right: 151/60 left: 144/55 height: 69" weight: 147 general: wdwn in nad skin: warm, dry and intact. sternotomy well healed. well healed upper abdominal incision. heent: ncat, perrla, eomi, sclera anicteric, op benign, teeth in fair repair neck: supple full rom no jvd chest: lungs clear bilaterally heart: irregular, high pitched iv/vi systolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused trace le edema varicosities: left gsv appears suitable on standing. there are some anterior varicosities noted. right is sugically absent with a well healed saphenectomy incision neuro: grossly intact pulses: femoral right:2 left:2 dp right:1 left:1 pt :2 left:1 radial right:2 left:2 carotid bruit transmitted bilat but ? bruit in left neck discharge exam: vs: t: 99.0 72-84 afib bp: 110-135/60-70 sats: 94% ra general: 84 year-old male in no apparent distress card: irregular, normal s1,s2 resp: decreased breath sounds bilateral late fine crackles at left base gi: benign extr: warm 1+ edema bilateral wound: sternal incision clean, dry intact, no erythema, discharge or sternal click. neuro: non-focal pertinent results: echo: prebypass: preserved lv systolic function with lvef> 55% but in the setting of moderate mr. the left atrium is moderately dilated. left ventricular wall thicknesses and cavity size are normal. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. no thoracic aortic dissection is seen. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen with vena contracta of around 0.5cm and jet area of 8cm2.. there is no pericardial effusion. intact ias. no clot seen in laa, dilated coronary sinus but no persistent left svc (normal entry of contrast throught the left arm iv. postbypass: mr is now trace. normally functioning bioprosthetic av with no significant regurg or stenosis. normal function. no dissection seen after aortic cannula removed. . cxr: : 1. status post median sternotomy with stable postoperative cardiac mediastinal contours. there is persistent but slightly less free intraperitoneal air underneath the right hemidiaphragm. there is persistent bibasilar air space opacities which likely reflects patchy atelectasis in the setting of small bilateral pleural effusions. no pulmonary edema. no evidence of pneumothorax. wbc-10.6 rbc-3.46*# hgb-10.3*# hct-30.3 plt ct-121* wbc-7.4 rbc-3.45* hgb-9.7* hct-30.5* plt ct-218 pt-17.9* inr(pt)-1.7* pt-18.5* inr(pt)-1.7* pt-25.6* inr(pt)-2.5* pt-12.7* inr(pt)-1.2* urean-31* creat-1.1 na-135 k-3.8 cl-97 glucose-134* urean-21* creat-1.2 na-137 k-3.9 cl-105 hco3-25 mg-1.9 brief hospital course: mr. was admitted a day before surgery due to being on coumadin for atrial fibrillation. he was placed on heparin and underwent surgical work-up on . the following day he was brought to the operating room where he underwent a redo-sternotomy, aortic valve replacement. please see operative note for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. within 24 hours he was weaned from sedation, awoke neurologically intact and extubated. on post-op day one he was started on beta-blockers and diuretics and diuresed towards his pre-op weight. later this day he was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. he worked with physical therapy for assistance with strength and mobility. coumadin was restarted for his chronic atrial fibrillation and will be followed by his cardiologist after discharge. he made good progress and was discharged to home with vna services on post-op day 4 with the appropriate medications and follow-up appointments. medications on admission: amoxicillin dental prophylaxis vitamin b 12 1000mcg injected monthly omeprazole 20mg daily maalox flomax 0.4mg daily **coumadin*** 4mg alt with 6mg on hold red yeast rice 600mg twice daily welchol 1250mg twice daily folic acid 1mg daily metoprolol 12.5mg twice daily aspirin 81mg daily on hold lasix 20mg discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 4. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). 5. acetaminophen 325 mg tablet sig: two (2) tablet po every six (6) hours as needed for pain, fever. 6. colesevelam 625 mg tablet sig: two (2) tablet po bid (2 times a day). 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 8. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 9. furosemide 40 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 10. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po once a day for 7 days. disp:*14 tablet extended release(s)* refills:*0* 11. tramadol 50 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 12. warfarin 2 mg tablet sig: one (1) tablet po once a day. 13. outpatient lab work hematocrit and hgb. results to be sent to dr. discharge disposition: home with service facility: tba discharge diagnosis: - aortic stenosis s/p redo-sterntomy, aortic valve replacement past history: - ptca with des to lad x2 in - atrial fibrillation - hypertension - hyperlipidemia - bph - pud nonbleeding - ventricular ectopy - cataracts - gastric lymphoma - b-12 deficiency - squamous cell cancer left ear - h/o gi bleed (transfused 2 units) - h/o peptic ulcer past surgical history: - coronary artery bypass graft x 2: , svg-lad, svg to rca - gastric lymphoma s/p partial gastrectomy with occ dumping syndrome - s/p left parathyroidectomy - s/p partial gastrectomy 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 leg right/left - healing well, no erythema or drainage. edema 1+ bilateral 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** followup instructions: you are scheduled for the following appointments wound check: , on at 10:15am surgeon: dr. on at 1:45pm in the cardiologist/pcp: . follow-up as directed **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication: chronic atrial fibrillation goal inr 2-2.5 first draw monday results to phone to dr. at procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension atrial fibrillation aortocoronary bypass status aortic valve disorders hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) percutaneous transluminal coronary angioplasty status personal history of other lymphatic and hematopoietic neoplasms personal history of other malignant neoplasm of skin long-term (current) use of anticoagulants personal history of peptic ulcer disease personal history of malignant neoplasm of stomach 

Answer: The patient is high likely exposed to