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 (sulfonamides) attending: chief complaint: murmur major surgical or invasive procedure: bentall procedure (25mm st. aortic valve graft) history of present illness: 76 y/o male who found to have a murmur on his routine physical exam. he then underwent an echo which revealed a dilated aorta and aortic insufficiency. he was then referred for surgery. past medical history: deep vein thrombosis, arthritis, melanoma s/p excision, hydrocele, glaucoma, s/p appendectomy, s/p hernia repair social history: tobacco: 4 pipes/day etoh glasses of scotch/day retired, lives at home with wife family history: father died of aortic aneurysm at 66. 3 cousins died of aortic anuerysms between 40-50. physical exam: heent: eomi, perrl, ncat neck: supple, from, -jvd, bruits pulm: ctab -w/r/r heart: rrr 3/6 murmur abd soft, nt/nd, +bs ext: warm, bilat varicosities, + edema neuro: a&o x 3, mae, non-focal pertinent results: 03:59pm blood wbc-10.2 rbc-3.57* hgb-11.5* hct-33.5* mcv-94 mch-32.3* mchc-34.4 rdw-13.1 plt ct-276# 08:45pm blood wbc-6.8 rbc-4.07* hgb-13.7* hct-38.9* mcv-96 mch-33.6* mchc-35.1* rdw-13.1 plt ct-235 06:40am blood pt-19.9* ptt-65.7* inr(pt)-1.9* 06:34pm blood pt-19.8* ptt-36.0* inr(pt)-1.8* 07:55am blood pt-18.3* inr(pt)-1.7* 08:25am blood pt-17.4* inr(pt)-1.6* 01:15pm blood pt-14.5* ptt-43.9* inr(pt)-1.3* 08:45pm blood pt-14.2* ptt-29.2 inr(pt)-1.2* 01:02pm blood glucose-134* urean-14 creat-0.8 na-132* k-4.2 cl-96 hco3-26 angap-14 08:45pm blood glucose-132* urean-10 creat-0.9 na-138 k-4.2 cl-103 hco3-26 angap-13 08:45pm blood alt-16 ast-23 alkphos-67 amylase-40 totbili-0.6 08:45pm blood lipase-34 01:02pm blood mg-2.0 radiology preliminary report chest (pa & lat) 2:17 pm chest (pa & lat) reason: evaluate effusion medical condition: 76 year old man s/p bentall reason for this examination: evaluate effusion indication: status post bentall. assess effusion. comparison: . pa and lateral chest: sternal wires and the valve prosthesis are unchanged from the prior exam. there is similar cardiomegaly and tortuosity of the aorta. there are small bilateral pleural effusions. no pneumonia, failure, or pneumothorax. impression: no short interval change in the appearance of the chest, with small bilateral pleural effusions. dr. dr. dr. echocardiography report , (complete) done at 10:49:03 am preliminary referring physician information , r. division of cardiothoracic , status: inpatient dob: age (years): 76 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: aortic valve disease. left ventricular function. valvular heart disease. icd-9 codes: 440.0 test information date/time: at 10:49 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2007aw02-: machine: echocardiographic measurements results measurements normal range aorta - sinus level: *4.5 cm <= 3.6 cm aorta - ascending: *6.5 cm <= 3.4 cm findings left atrium: moderate la enlargement. no spontaneous echo contrast or thrombus in the body of the laa. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. no asd by 2d or color doppler. left ventricle: normal lv wall thickness and cavity size. right ventricle: normal rv chamber size and free wall motion. aorta: moderately dilated aortic sinus. markedly dilated ascending aorta. mildly dilated descending aorta. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. moderately thickened aortic valve leaflets. no as. moderate to severe (3+) ar. mitral valve: mildly thickened mitral valve leaflets. moderately thickened mitral valve leaflets. mild mitral annular calcification. physiologic mr (within normal limits). tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. suboptimal image quality - poor echo windows. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-bypass: the left atrium is moderately dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. right ventricular chamber size and free wall motion are normal. the aortic root is moderately dilated at the sinus level. the ascending aorta is markedly dilated the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is no aortic valve stenosis. moderate to severe (3+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the mitral valve leaflets are moderately thickened. physiologic mitral regurgitation is seen (within normal limits). there is no pericardial effusion. post cpb: 1. preserved -ventricular systolic function 2. mechanical prosthesis in aortic position. weall seated and stable. 3. trace ai 4. tube graft in ascending aortic position. no other change interpretation assigned to , md, interpreting physician cardiology report ecg study date of 2:34:56 pm baseline artifact. sinus rhythm. non-diagnostic q waves in leads ii, iii and avf with probable st-t wave abnormalities. however, artifact precludes clear visualization of the st segments. early r wave progression. precordial t wave inversions. there is a single atrial premature beat. since the previous tracing of the atrial premature beat is new and is probably paced. inferior st-t wave abnormalities may have appeared as well as the inferior q waves. clinical correlation is suggested. read by: , a. intervals axes rate pr qrs qt/qtc p qrs t 76 0 88 398/426 0 7 17 brief hospital course: mr. was admitted pre-operatively for further cardiac work-up and to initiate heparin therapy (d/t pt. previously being on coumadin). on he underwent a cardiac cath which ruled out any coronary artery disease, but did reveal ai and a dilated aorta. on he was brought to the operating room where he underwent a bentall procedure. please see op 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 gently diuresed towards his pre-op weight. later on this day his chest tubes were removed and he was transferred to the sdu for further care. coumadin was initiated and heparin was used as a bridge until patient was therapeutic. epicardial pacing wires were removed per protocol. physical therapy worked with him on strength and mobility. he was ready for discharge to rehab on pod 5. plan for follow up at rehab for coumadin dosing, he has received 4mg , 5mg , 7.5mg . first draw wednesday at rehab. medications on admission: xalantan gtts, coumadin (stopped 1 wk before admission), prednisone (stopped 2 wks before admission), timolol gtts, alphagan gtts 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. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 4. timolol maleate 0.25 % drops sig: one (1) drop ophthalmic daily (daily). 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. warfarin 1 mg tablet sig: goal inr 2.5-3.0 tablets po once a day: please dose based on inr - draws mon/wed/fri goal inr 2.5-3.0 mech avr . 8. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed. tablet(s) 9. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. tablet(s) 10. furosemide 40 mg tablet sig: one (1) tablet po once a day for 7 days. 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 7 days. 12. thiamine hcl 100 mg tablet sig: one (1) tablet po once a day. 13. multivitamins tablet, chewable sig: one (1) tablet, chewable po once a day. 14. folic acid 1 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: ascending aortic aneurysm, aortic insufficiency s/p bentall procedure pmh: deep vein thrombosis, arthritis, melanoma s/p excision, hydrocele, glaucoma, s/p appendectomy, 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. gently pat the wound dry. 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 followup instructions: dr. in 4 weeks dr. after discharge from rehab labs: pt/inr mon/wed/fri for dosing - goal 2.5-3.0 for mechanical aortic valve procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization diagnostic ultrasound of heart open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels aortography other repair of vessel diagnoses: tobacco use disorder unspecified pleural effusion thoracic aneurysm without mention of rupture aortic valve disorders unspecified glaucoma long-term (current) use of anticoagulants personal history of venous thrombosis and embolism primary hypercoagulable state alcohol abuse, continuous personal history of malignant melanoma of skin diverticulosis of colon (without mention of hemorrhage) cyst of kidney, acquired arthropathy, unspecified, site unspecified 

Answer: The patient is high likely exposed to