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: no known allergies / adverse drug reactions attending: chief complaint: palpitations major surgical or invasive procedure: redo sternotomy with pericardial patch repair of homograft perforation in the pseudoaneurysm. aortic valve replacement with a 19-mm st. medical regent mechanical heart valve. mediastinal irrigation and sternal wound closure. history of present illness: 61 year old gentleman with past medical history of congenital aortic stenosis treated with open valvulaplasty in and then a redo homograft root replacement and proximal arch replacement in . he has done quite well since that time. on routine follow-up with dr. this an echocardiogram was obtained which showed the ascending aorta to be moderately dilated (5.2cm) and an abnormality exterior to the tube graft. a ct scan was performed which revealed an aneurysmal sac which measures 6.5cm. past medical history: aortic pseudoaneurysm aortic stenosis s/p redo sternotomy, pseudoaneurysm repair, avr (mechanical) - congential aortic stenosis s/p open valvulplasty and bentall - ascending aortic aneurysm - benign prostatic hypertrophy - erectile dysfunction - hypertension - aortic valvuloplasty - redo sternotomy/bentall/prox.arch repl. (homograft to gelweave)) (dr. - vasectomy social history: lives with: wife occupation: works for a federal agency that performs audits and financial analyses of federal contractors. cigarettes: smoked no yes hx: quit etoh: < 1 drink/week illicit drug use: none family history: non contributory physical exam: pulse: 66 resp: 16 o2 sat: 99% b/p right: 128/76 height: 71" weight: 150 general: well-developed male in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema/varicosities: none 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: - pertinent results: admission labs: 07:42am hgb-12.9* calchct-39 07:42am glucose-79 lactate-0.9 na+-132* k+-4.0 cl--100 01:00pm fibrinoge-100* 01:00pm pt-18.9* ptt-77.4* inr(pt)-1.7* 01:00pm wbc-10.2# rbc-2.83*# hgb-9.0*# hct-25.8*# mcv-91 mch-31.8 mchc-34.9 rdw-13.3 12:56pm glucose-143* lactate-4.9* na+-133 k+-3.7 cl--104 discharge labs 06:03am blood wbc-8.2 rbc-2.97* hgb-9.0* hct-26.8* mcv-90 mch-30.3 mchc-33.6 rdw-13.7 plt ct-220 06:03am blood plt ct-11/1220 06:03am blood pt-27.5* ptt-74.2* inr(pt)-2.6* 06:03am blood glucose-91 urean-19 creat-1.3* na-131* k-4.5 cl-100 hco3-21* angap-15 inr labs 06:03am blood pt-27.5* ptt-74.2* inr(pt)-2.6* 03:56am blood pt-20.4* ptt-73.7* inr(pt)-1.9* 06:12am blood pt-19.1* ptt-77.4* inr(pt)-1.7* 02:00pm blood pt-18.9* ptt-50.9* inr(pt)-1.7* 03:52am blood pt-18.8* ptt-86.6* inr(pt)-1.7* 01:33pm blood pt-18.1* ptt-57.5* inr(pt)-1.6* 02:12am blood pt-19.1* ptt-57.3* inr(pt)-1.7* 11:02pm blood pt-19.1* ptt-52.8* inr(pt)-1.7* 06:18am blood pt-19.8* ptt-42.7* inr(pt)-1.8* 11:33pm blood pt-17.6* ptt-37.6* inr(pt)-1.6* 02:47am blood pt-12.6 ptt-25.0 inr(pt)-1.1 intra-op tee conclusions pre-chestclosure the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. there is abnormal diastolic septal motion/position consistent with right ventricular volume overload. the aortic valve prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. there is left sided pleural effusion. post_chest closure moderate global rv systolic dysfunction. intact ascending aortic graft. the aortic mechanical valve is entirely normal with standard washing jets. radiology report chest port. line placement study 12:25 pm final report comparison is made to the patient's prior study of at 16:02. impression: 1. interval removal of the right internal jugular introducer with placement of a central line which has its tip in the superior vena cava. no evidence of pneumothorax. 2. stable postoperative appearance to the cardiac and mediastinal contours with persistent prominence in the left hilum in the region of the pulmonary artery. the patient is status post median sternotomy for cabg and aortic valve replacement. persistent bibasilar patchy opacities, left greater than right with associated layering pleural effusions most likely representing compressive atelectasis although pneumonia cannot be excluded. no evidence of pulmonary edema. brief hospital course: admitted same day surgery and was brought to the operating room for planned repair of pseudoaneurysm however was complicated by tear in graft, innominate tear, requiring deep hypothermic circulatory arrest, see operative report for further details. he tolerated the operation and was brought to the intensive care unit from the operating room with chest open and chemically paralyzed/sedated. he required both inotropic support pressor support for blood pressure managment. on post operative day one his paralytic was temporarily stopped to evaluate neurological status and he opened his eyes to command, he was then resumed on paralytics to reduce potential for complication with open chest. he continued on sedation and was gently diuresed with lasix due to volume overload. on , post operative day two, he returned to the operating room for wash out and sternal closure, see operative report for further details. he was not restarted on paralytics post closure but continued on sedation until paralytics cleared. he was in atrial fibrillation on return from the operating room. he was then transitioned to precedex and weaned from the ventilator, but remained intubated until the morning of post operative day four. post extubation he experienced post-operative delerium which was managed with haldol initially, this cleared and on post operative day seven and five he was transferred to the floor for continued care. the remainder of his hospital course was uneventful. he continued on heparin drip as he continued to be loaded with coumadin for mechanical valve and atrial fibrillation. he was discharged home with vna on pod 11 when inr was therapeutic. coumadin/inr will be managed by dr. via the clinic. medications on admission: toprol xl 50 mg daily aspirin 325 mg daily viagra prn discharge medications: 1. outpatient lab work labs: pt/inr for coumadin ?????? indication aortic valve goal inr 2.5-3 first draw results to clinic, phone 2. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. 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:*2* 5. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. metoprolol tartrate 50 mg tablet sig: 2.5 tablets po tid (3 times a day). disp:*225 tablet(s)* refills:*2* 7. warfarin 2.5 mg tablet sig: as directed tablet po once a day: take 5mg on , and then as directed by coumadin clinic. disp:*75 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: aortic pseudoaneurysm aortic stenosis s/p redo sternotomy, pseudoaneurysm repair, avr (mechanical) pmh congential aortic stenosis s/p bentall benign prostatic hypertrophy hypertension discharge condition: alert and oriented x3 nonfocal ambulating independently- steady gait incisional pain managed with tramadol incisions: sternal - healing well, no erythema or drainage, staples edema- trace bilaterally 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 one month or while taking narcotics. driving will be discussed at follow up appointment with surgeon. no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **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 surgeon: dr on 1:15pm in the medical office building cardiologist: dr. on 10:20 pcp dr on 3:00 please call to schedule appointments with your primary care dr in weeks **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 aortic valve goal inr 2.5-3 first draw results to clinic, phone procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery other revision of vascular procedure open and other replacement of aortic valve other repair or plastic operations on bone, scapula, clavicle, and thorax [ribs and sternum] repair of blood vessel with synthetic patch graft other repair of heart and pericardium diagnoses: acidosis thrombocytopenia, unspecified unspecified essential hypertension acute posthemorrhagic anemia thoracic aneurysm without mention of rupture atrial fibrillation aortic valve disorders hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) hemorrhage complicating a procedure surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants other and unspecified coagulation defects mechanical complication of other vascular device, implant, and graft other alteration of consciousness acute respiratory failure following trauma and surgery other fluid overload hallucinations impotence of organic origin 

Answer: The patient is high likely exposed to