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 40 year old gentleman with known bicuspid aortic valve and hepatitis a. the patient had an echocardiogram previously done in which showed mild aortic stenosis and no aortic insufficiency. on a recent visit with his primary care physician he was noted to have a new heart murmur. the patient had an echocardiogram done at an outside hospital on which demonstrated a moderately dilated left aorta and left ventricle with an ejection fraction of approximately 60%. the patient also had moderately severe aortic insufficiency and mild aortic stenosis. as a result of this echocardiogram the patient underwent a cardiac magnetic resonance imaging scan on . the results of the study were as follows: 1. bicuspid aortic valve with moderate severe aortic regurgitation; 2. moderate dilation of aortic root and ascending aorta; 3. severely dilated left ventricular cavity size with normal regional and global left ventricular systolic function; 4. left ventricular ejection fraction normal at 66%; 5. normal right ventricular cavity size and function; 6. moderately dilated main pulmonary artery; 7. bilateral enlargement. this study was ordered by dr. . the patient was referred for a cardiac catheterization to determine the central need for surgery. on , the patient underwent a cardiac catheterization. the cardiac catheterization revealed normal coronary arteries; severe aortic regurgitation with aortic root dilation; mild aortic stenosis; preserved systolic ventricular function. following the cardiac catheterization the patient was referred to dr. for aortic valve replacement. past medical history: 1. the patient's past medical history is significant for aortic valve disease. 2. hepatitis a. 3. allergic rhinitis. 4. status post vasectomy. social history: the patient is married, lives with his wife three children. the patient works as a medical technician at . allergies: the patient is allergic to penicillin. medications on admission: 1. zestril 10 mg q.d. 2. multivitamin q.d. review of systems: the patient denied any visual changes, dysphagia, shortness of breath, hematochezia, melena, dysuria, transient ischemic attack symptoms. the patient did describe feeling palpitations with exertion. physical examination: on presentation the patient's physical examination revealed that he was a pleasant male in no apparent distress who was alert and oriented times three. he was afebrile. the heart rate was 76 in sinus rhythm. blood pressure was 89/53. respiratory, breathing 20 breaths/minute with a saturation of 100% on room air. the patient's head, eyes, ears, nose and throat examination, pupils equal, round and reactive to light, extraocular movements intact, oropharynx was clear with good dentition, no jugulovenous distension, no bruits. neck was supple. carotid artery pulses were 2+ bilaterally. the patient's lung examination was even and unlabored, clear to auscultation bilaterally. the patient's cardiac examination revealed a regular rate and rhythm with a iii/vi systolic ejection murmur; the patient's abdominal examination revealed positive bowel sounds, soft, nontender, nondistended. the patient's extremity examination showed 2+ bilateral pulses, dorsalis pedis and posterior tibialis. the patient's extremities were not erythematous or edematous. neurological examination, the patient was alert and oriented times three. cranial nerves ii through xii were grossly intact. hospital course: the patient was admitted and underwent an aortic root and transverse arch replacement with aortic valve replacement with aortic valve replacement on . an aortic valve replacement was done with a 29 mm cv pericardial valve. the aortic root and transverse arch replacement was done with 28 mm gel-weave graft. the procedure was done by dr. and assisted by dr. , md , pa cardiac. the patient was placed on a pulmonary bypass time of 185 minutes and a crossclamp time of 139 minutes. the patient was under complete circulatory arrest for 14 minutes. the patient tolerated the procedure well and was transferred to the intensive care unit with levophed, epinephrine, and propofol drips. the patient also had two atrial and two ventricular pacing wires. over the postoperative night the patient was extubated without complications and remained on levophed and epinephrine drips to keep the systolic blood pressure 95 to 110. that evening was only complicated by one small run of atrial fibrillation which converted without any intervention. following expiration the patient's lung fields were clear with diminished bases bilaterally but was able to maintain oxygen saturations at 100% while on 2 liters of nasal cannula. the patient's chest tube had minimal serosanguinous drainage and no air leak noted. on postoperative day #1 the patient was successfully weaned off of his levophed and epinephrine drips. the patient's pulmonary status continued to improve, he was able to maintain oxygen saturation while being weaned off of 2 liters of nasal cannula. the patient was transferred out of the cardiac surgery recovery unit to the surgical floor. the patient was transferred with two atrial and two ventricular pacing wires as well as two chest tubes. the chest tubes were draining a small amount of serosanguinous fluids. the patient continued to have an uncomplicated postoperative course. both of his chest tubes were removed on postoperative day #2. the patient tolerated the procedure well. the patient was seen and evaluated by physical therapy and it was determined that after one more session the patient would be cleared to go home. the patient had her pacing wires discontinued on postoperative day #3. the patient remains in sinus rhythm with a rate of approximately 70 to 90. the patient had a serial hematocrit performed throughout his postoperative course and noticed that hematocrit level had dropped to a nadir of 19.6. the patient was offered the choice of transfusion versus medication with iron and vitamin c. the patient refused the transfusion, having concerns over the transition of hepatitis. the patient was started on sefo4 325 mg p.o. q.d. and ascorbic acid 500 mg p.o. b.i.d. hematocrit levels taken the following day showed an increase of 21.4. the patient stated that he felt considerably better, less lethargic, and more energetic. by postoperative day #5, it was felt that the patient was ready and stable to be discharged to home for further continuation of recovery of the cardiac surgery. the remainder of this dictation will be completed when the patient leaves in the morning. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels diagnoses: thoracic aneurysm without mention of rupture atrial fibrillation aortic valve disorders viral hepatitis a without mention of hepatic coma congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to