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: painful left foot major surgical or invasive procedure: aortic valve replacement(21mm pericardial) and single vessel coronary artery bypass grafting utilizing saphenous vein graft to right coronary artery. tunnel line placement extraction of 5 teeth, numbers 3, 14, 20, 23 and 26. history of present illness: mr. is a 79 year old male with extensive medical history, including known aortic stenosis, who presented to osh for management of painful ischemia of the left foot. despite endovascular intervention on , the patient developed gangrene of the left toes. surgical intervention has been withheld in the setting of known aortic stenosis, coronary disease and end stage renal failure. he presents to the for consideration of avr/cabg prior to vascular bypass. past medical history: - aortic stenosis, history of syncope - coronary artery disease - hypertension - hypercholesterolemia - non-ischemic cardiomyopathy - diabetes mellitus - peripheral vascular disease with gangrenous left foot - anemia - end stage renal failure - paroxysmal atrial fibrillation - s/p left tibial artery stent - s/p aicd (guidant), - s/p rue av fistula for dialysis - s/p tonsillectomy social history: lives with: wife : 4 pack years, quit 20yrs ago etoh: 1 wine/week family history: non-contributory physical exam: pulse: 81 resp: 20 o2 sat: 97%ra bp right: 105/80 height: 5'5" weight: 63.5 kg general: elderly male in no acute distress skin: dry intact lipoma- mid- sternum heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 3/6 sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none cool, poorly perfused, gangrenous left toes, no edema, multiple scabs lower extremities neuro: grossly intact pulses: femoral right: cath site left: 2+ dp right: 1+ left:np pt : np left:np radial right: 1+ left: 1+ carotid bruit: no bruits appreciated pertinent results: wbc-11.6* rbc-3.50* hgb-10.0* hct-31.5* plt ct-202 pt-17.2* ptt-46.9* inr(pt)-1.5* urean-96* creat-6.1* na-143 k-4.3 cl-108 hco3-17* angap-22* alt-2 ast-14 ld(ldh)-334* alkphos-69 totbili-0.6 albumin-3.6 calcium-8.4 phos-6.5* mg-2.2 %hba1c-5.9 chest ct scan: 1. heavy calcification of the aortic valve, with calcifications seen along the left lateral wall of the ascending aorta. remainder of the aorta beyond the aortic arch is more heavily calcified. coronary artery calcifications. 2. multiple tiny peripheral and subpleural lung nodules, some calcified, all measuring less than 4 mm. these may represent noncalcified as well as calcified granulomas, however, if the patient is at high risk for intrathoracic malignancy, followup ct chest would be recommended in 12 months' time, otherwise no further followup would be recommended by the society guidelines. 3. small areas of consolidation, in the right upper and left lower lobes, most probably infectious or inflammatory in etiology, however, followup ct may be considered to document resolution and to exclude underlying malignancy, particularly in the right upper lobe. 4. prominent lymph nodes, particularly in the retroperitoneum. clinical significance of these is indeterminate, and followup ct would be recommended to evaluate stability of mediastinal and retroperitoneal lymph nodes. 5. cholelithiasis. echocardiogram: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 70%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is severe mitral annular calcification. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. carotid ultrasound: there is less than 40% stenosis within the internal carotid arteries bilaterally. 06:42am blood wbc-13.0* rbc-3.23* hgb-9.8* hct-30.6* mcv-95 mch-30.4 mchc-32.1 rdw-20.0* plt ct-171 07:30am blood neuts-83* bands-0 lymphs-4* monos-4 eos-8* baso-1 atyps-0 metas-0 myelos-0 nrbc-1* 07:30am blood hypochr-3+ anisocy-2+ poiklo-1+ macrocy-1+ microcy-normal polychr-1+ ovalocy-1+ schisto-1+ 06:42am blood plt ct-171 06:42am blood pt-26.7* ptt-47.6* inr(pt)-2.6* 07:30am blood fibrino-550* 04:32am blood eos ct-420 06:42am blood glucose-120* urean-30* creat-4.0* na-144 k-3.5 cl-102 hco3-31 angap-15 05:25am blood alt-36 ast-52* ld(ldh)-444* alkphos-109 totbili-1.7* 07:30am blood lipase-62* 06:42am blood calcium-8.5 phos-4.2 mg-2.5 08:14am blood caltibc-228* ferritn-307 trf-175* 04:50pm blood %hba1c-5.9 06:50am blood pth-208* 04:30pm blood hbsag-negative hbsab-negative hbcab-negative 09:20am blood vanco-12.9 specimen submitted: aortic valve leaflets. procedure date tissue received report date diagnosed by dr. /vf previous biopsies: teeth #s: 3, 14, 20, 23, and 26.. diagnosis: aortic valve leaflets: calcific valvulopathy. brief hospital course: mr. was admitted to the cardiac surgical service. given atrial fibrillation, he was maintained on intravenous heparin. he otherwise remained stable on medical therapy and underwent extensive preoperative evaluation by the vascular, renal and dental services. given his declining renal function, a temporary tunnelled catheter was placed for dialysis on . vascular surgery saw the patient for dry gangrene of the left toes. he was eventually cleared by the vascular service and required teeth extraction prior to cardiac surgical intervention. preoperative course was also notable for a positive urine analysis which was treated with a three day course of ciprofloxacin. on he was taken to the operating room and underwent coronary artery bypass grafting x1 (saphenous vein grafted to the right coronary artery)/aortic valve replacement (#21mm ce magna tissue valve). please refer to dr. operative report for further details. cardiopulmonary bypass time=115 minutes. cross clamp time=83minutes. mr. was intubated and sedated, transferred to the cvicu in stable but critical condition, requiring epinephrine to optimize cardiac function. in the first twenty four hours he was weaned from sedation, awoke, and was extubated. he underwent hemodialysis on post operative day one and pressors were weaned as tolerated. hematology was consulted due to arterial clots noted intraoperative, see tee report, and was worked up for dic but was felt to be vitamin k deficient. coumadin had been started on post operative day one and held when inr > 2.5, restarted with 1 mg, as required anticoagulation for atrial fibrillation. he remained in the intensive care unit for hemodynamic and pulmonary monitoring but on post operative day four he was transferred to the floor for the remainder of his stay. physical therapy worked with him however limited by left foot dry gangrene. he continued to progress and underwent dialysis am. he is ready for discharge to rehab with plan for follow up with vascular surgery at for left foot dry gangrene. rehab to call consult to dr , he can follow his foot at rehab. medications on admission: transfer meds: protonix 40', nifedipine 60', lipitor 10', metoprolol 25'', zemplar 1mcg', ancef 1g q8h, lasix 80 po qd, regular insulin sliding scale, acetylcysteine 600'', procrit 10,000u sc qweek, discharge disposition: extended care facility: northeast - discharge diagnosis: aortic stenosis s/p avr coronary artery disease s/p cabg end stage renal failure, on dialysis atrial fibrillation hypertension dyslipidemia peripheral vascular disease with dry gangrene of left toes discharge condition: alert and oriented x2 nonfocal pivot w/ assist of 2 no weight bearing left foot sternal and left foot pain managed with neurotin tid and tylenol prn discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 approximately one month until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns please keep toes separated with 2x2 to keep between toes dry - left foot with dry gamgrene - to follow up with vascular surgery consult to be called at rehab to dr , plan for surgery in after recovery from heart surgery followup instructions: heart center see appointments below hc - dr (for dr - thrusday at 915 am hc - dr at 1130 am primary care dr. after discharge from rehab consult to be called at rehab please call consult to dr for vascular follow up at rehab on monday - will need further surgery on left foot in procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery hemodialysis venous catheterization for renal dialysis (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft extraction of other tooth excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: other primary cardiomyopathies anemia in chronic kidney disease end stage renal disease coronary atherosclerosis of native coronary artery urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified atrial fibrillation aortic valve disorders hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia long-term (current) use of anticoagulants automatic implantable cardiac defibrillator in situ atherosclerosis of native arteries of the extremities with gangrene dental caries, unspecified ulcer of heel and midfoot endocarditis, valve unspecified, unspecified cause other ill-defined heart diseases deficiency of vitamin k 

Answer: The patient is high likely exposed to