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: patient recorded as having no known allergies to drugs attending: chief complaint: asymptomatic with known aneurysm major surgical or invasive procedure: asc. aorta and hemi-arch replacement with 28mm gelweave graft, aortic valve replacement w/ 25mm on-x mechanical valve history of present illness: 60 y/o male with know aortic valve disease and dilated ascending aorta for approximately 2 years. he remains asymptomatic and been followed by serial echo and ct scans. most recent chest ct revealed asc. aorta measuring 5.4 cm. past medical history: ascending aortic aneurysm, bicuspid aortic valve with mild as/ai, hypertension, h/o lyme disease, nephrolithiasis s/p lithotripsy, ?gout, mild bph, mild arthritis, s/p hernia repair social history: denies tobacco use. occasional etoh use. family history: non-contributory physical exam: vs: 58 18 129/81 general: wdwn male in nad skin: w/d, -lesions heent: nc/at, eomi, perrl neck: supple, from -jvd, -carotid bruit w/ transmitted murmur chest: ctab -w/r/r heart: rrr w/ 3/6 sem abd: soft, nt/nd, =bs ext: warm, well-perfused -c/c/e, -varicosities, 2+ pulses neuro: mae, a&o x 3, non-focal pertinent results: echo : pre-cpb no spontaneous echo contrast is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). right ventricular systolic function is borderline normal. the ascending aorta is moderately dilated. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve is bicuspid. the aortic valve leaflets are moderately thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. trace-mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is a trivial/physiologic pericardial effusion. post-cpb borderline normal right ventricular systolic function. normal left ventricular systolic function. there is a bileaflet prosthesis in the aortic position. it is seen only in limited views. it appears to be well seated. a few images appear to reveal normal leaflet function. there is trace valvular aortic regurgitation that is normal for this prosthesis. a small perivalvular leak can not be completely ruled out. there is no aortic stenosis. the ascending aorta is s/p graft replacement. it is poorly seen and can not be commented on. the descending thoracic aorta is intact. 02:46pm blood wbc-12.2*# rbc-2.60*# hgb-8.6*# hct-24.1*# mcv-93 mch-33.1* mchc-35.8* rdw-13.4 plt ct-91*# 07:10am blood wbc-16.7* rbc-3.45* hgb-11.1* hct-32.5* mcv-94 mch-32.1* mchc-34.1 rdw-13.0 plt ct-146* 02:46pm blood pt-17.4* ptt-43.7* inr(pt)-1.6* 07:10am blood pt-13.2* inr(pt)-1.1 07:10am blood glucose-133* urean-20 creat-0.9 na-141 k-4.0 cl-104 hco3-30 angap-11 04:10pm blood urean-15 creat-0.8 cl-116* hco3-26 brief hospital course: mr. was a same day admit after undergoing all pre-operative work-up as an outpatient. on day of admission he was brought to the operating room where he underwent asc. aorta and hemi-arch replacement and aortic valve replacement on . please see op note for surgical details. following surgery he was brought to the csru for invasive monitoring in stable condition. within 24 hours he was weaned from sedation, awoke neurological intact and was extubated. on post-op day one his chest tubes were removed and he was transferred to the telemetry floor for further care. he was also started on beta blockers and diuretics and gently diuresed towards his pre-op weight. on post-op day two his epicardial pacing wires were removed. went into a fib on pod #3, with intermittent a fib over next 2 days. heparin drip started until inr increased appropriately. inr 1.8 on pod #7 and cleared for discharge by dr. . target inr is 2.5- 3.0 for mechanical avr. coumadin dosing /inr follow- up with dr. . first blood draw .pt. is to make all follow-up appts. as per discharge instructions. medications on admission: toprol xl 25mg qd, norvasc 5mg qd,amoxicillin prophylaxis discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 2. 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:*0* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 1 months. disp:*60 tablet(s)* refills:*0* 5. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. warfarin 5 mg tablet sig: goal inr 2.5-3.0 tablets po once a day: dose based on inr . disp:*60 tablet(s)* refills:*2* 7. warfarin 1 mg tablet sig: goal inr 2.5-3.0 tablets po once a day: dose based on inr. disp:*120 tablet(s)* refills:*2* 8. coumadin dosing please take 7.5mg and - then have blood drawn and contact pcp for further dosing 9. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: ascending aortic aneurysm and bicuspid aortic valve s/p asc. aorta and hemi-arch replacement, aortic valve replacement pmh: hypertension, h/o lyme disease, nephrolithiasis s/p lithotripsy, ?gout, mild bph, mild arthritis, s/p hernia repair discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month. 7) call with any questions or concerns. 8) coumadin dosing to be managed by dr. . please have inr checked daily and take coumadin as instructed by dr. . goal inr is 2.5-3.0 for mechanical valve. p instructions: dr. in 4 weeks dr. in weeks dr. in weeks wound check 2 please schedule with rn procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels diagnoses: pure hypercholesterolemia unspecified essential hypertension thoracic aneurysm without mention of rupture gout, unspecified atrial fibrillation aortic valve disorders hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to