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: history of present illness: the patient is a 48-year-old male with prior cardiac history significant for coronary artery disease, history of myocardial infarction, history of congestive heart failure, cardiomyopathy and aortic regurgitation. the patient's aortic insufficiency has progressed from moderate to severe over the last several years. the patient claimed that he had a few symptoms. however, his wife stated that he has had more dyspnea on exertion and fatigue recently. the patient smokes approximately one pack a day. he is overweight. the patient denies any chest pain. the patient also has a history of sleep apnea. a recently performed echocardiogram showed moderate severe aortic insufficiency with ejection fraction of approximately 25%. a repeat cardiac catheterization performed on showed one vessel branch coronary artery disease, moderate to severe aortic regurgitation, severe global left ventricular systolic dysfunction, mild biventricular systolic dysfunction and mild pulmonary arterial diastolic hypertension. at the time, the left ventricular ejection fraction was estimated to be 29%. given the patient's worsening symptoms, the decision was made to proceed with an aortic valve replacement as a long term solution. past medical history: 1. echocardiogram with ejection fraction of 20% to 25% with multiple wall motion abnormalities including apical akinesis, anteroseptal hypokinesis/akinesis, inferior hypokinesis/akinesis as well as lateral hypokinesis/akinesis. 2. congestive heart failure with ejection fraction of 20% to 29%. history of myocardial infarction. 3. aortic insufficiency 4. cardiomyopathy 5. coronary artery disease 6. sleep apnea past surgical history: no known surgical history. medications: 1. coumadin 5 mg po q day 2. lipitor 20 mg po q day 3. mavik 4 mg po q day 4. lasix 40 mg po q day 5. toprol xl 25 mg po q day allergies: no known drug allergies. physical examination: vital signs: afebrile, heart rate 70 and sinus rhythm, blood pressure 130/81. general: alert and oriented in no apparent distress, obese white male. head, ears, eyes, nose and throat: within normal limits. no evidence of jugular venous distention. no evidence of bruits. pulmonary: clear to auscultation bilaterally. cardiac: sinus rhythm, 2/6 systolic murmur and diastolic murmur. abdomen: obese, soft, nontender. extremities: no edema, pulses present and are palpable bilaterally. laboratory studies on admission: hematocrit 30.5, white blood cell count 10.2, platelets 122. ptt 35.2, pt 12.2, inr 1.0. glucose 119, bun 14, creatinine 0.9. sodium 136, potassium 4.7. imaging: preoperative chest x-ray was within normal limits. summary of hospital course: the patient was admitted to cardiac surgery service. given symptomatic aortic insufficiency and also history of congestive heart failure, it was decided that a surgical intervention would be appropriate. on , the patient underwent aortic valve replacement with a 23 mm carbomedics mechanical valve. the procedure was without any complications. the patient tolerated the procedure well. please see the full operative note for details. the patient remained intubated and was transferred to the intensive care unit for further management in stable condition. the patient was extubated on the same day. his oxygenation remained good. he was making adequate urine. postoperatively, the patient's arterial blood gas was ph 7.38, pco2 of 34, po2 of 110. his hematocrit was stable at 30.5. the patient was further diuresed. he was transferred to the regular floor on postoperative day 1 in good condition. the patient continued to have excellent oxygenation on minimal supplemental oxygen. physical therapy was consulted which followed the patient throughout his hospitalization and then officially cleared him to go home. anticoagulation with coumadin was restarted. given the presence of a mechanical valve, an inr of 2.5 to 3 was set as the goal. the patient remained afebrile. he remained in sinus rhythm. his lungs were clear to auscultation bilaterally. his pacing wires were removed on postoperative day 3. his urine catheter was removed on postoperative day 2. the patient was also started on intravenous heparin on postoperative day 3 given slow rise in the nr level. the patient was ambulating without assistance. the patient was continued to be diuresed with lasix. he had 1+ lower extremity edema bilaterally. his incision was clean, dry and intact throughout this hospitalization course. on the date of discharge, his inr was 1.9. the patient was discharged to home on postoperative day 6. discharge condition: stable discharge disposition: home discharge diagnoses: 1. severe aortic insufficiency, status post aortic valve replacement with a 23 mm carbomedics mechanical valve. 2. congestive heart failure 3. cardiomyopathy 4. sleep apnea discharge medications; 1. lasix 20 mg po bid x14 days 2. lipitor 20 mg po q day 3. lopressor 50 mg po bid 4. coumadin 7.5 mg on and 7.5 mg on (to follow up at the clinic for further dosing). 5. potassium chloride 20 milliequivalents po bid x14 days 6. colace 100 mg po bid 7. percocet 1 to 2 tablets po q 4 to 6 hours prn pain discharge instructions: 1. the patient is to follow up with his surgeon, dr. , in approximately for weeks. 2. the patient is to follow up with dr. grape, who is his primary care physician and cardiologist, in approximately one week. 3. the patient is to follow up at the clinic in two days to have his inr levels drawn and his coumadin levels adjusted. dr., 02-229 dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: other primary cardiomyopathies coronary atherosclerosis of native coronary artery congestive heart failure, unspecified aortic valve disorders other chronic pulmonary heart diseases unspecified sleep apnea old myocardial infarction 

Answer: The patient is high likely exposed to