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: fatigue, doe major surgical or invasive procedure: redo-redosternotomy/avr(#21 ) history of present illness: 61 yo m with s/p avr x 2 (last in ) with recent echo showing increased gradient and thickened/defromed leaflets. past medical history: pmh: 1. alcohol detox 2 wks ago 2. abdominal malignancy - 2.7cm iliac ln/abdominal lad currently being worked up by dr. 3. bicuspid aorta s/p aortic valve replacement with porcine valve in 4.presence of venous angioma vs av malformation seen on prior mras. 5. status post traumatic splenectomy 6. depression 7. essential tremor 8. status post bilateral herniorrhaphy 9. status post right thumb surgery . status post acl repair. social history: retired police officer occasional cigars occasional binge drinker, history of etoh abuse family history: gm with open heart surgery (unclear indication) physical exam: nad hr 70 bp 110/60 poor dentition lungs ctab heart rrr 3/6 sem -> carotids abdomen soft/nt/nd extrem warm, trace le edema mild l gsv varicosities tremor pertinent results: 06:00am blood wbc-16.5* rbc-3.37* hgb-10.8* hct-32.6* mcv-97 mch-32.0 mchc-33.1 rdw-16.5* plt ct-680* 06:00am blood pt-23.9* inr(pt)-2.3* 07:30am blood pt-23.6* inr(pt)-2.3* 12:45pm blood pt-25.0* inr(pt)-2.5* 06:20am blood pt-24.7* inr(pt)-2.4* 06:00am blood pt-28.4* inr(pt)-2.9* 06:00am blood glucose-99 urean-13 creat-0.8 na-137 k-4.4 cl-100 hco3-30 angap-11 chest (portable ap) 1:34 pm chest (portable ap) reason: ? infiltrate medical condition: 61 year old man with cabg reason for this examination: ? infiltrate study: ap chest, . history: 61-year-old male with cabg. evaluate for infiltrate. findings: comparison is made to previous study from . there has been no interval change. there is persistent bibasilar subsegmental atelectasis. no focal consolidation or overt pulmonary edema is seen. the right cp angle has been cutoff from the study. echocardiography report , (complete) done at 10:23:53 am final referring physician information , r. division of cardiothoracic , status: inpatient dob: age (years): 61 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: aortic valve disease. h/o cardiac surgery. left ventricular function. mitral valve disease. prosthetic valve function. valvular heart disease. icd-9 codes: 440.0, v43.3, 396.9 test information date/time: at 10:23 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 #: 2008aw04-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.9 cm <= 4.0 cm left atrium - four chamber length: 4.8 cm <= 5.2 cm left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.6 cm <= 5.6 cm left ventricle - systolic dimension: 4.8 cm left ventricle - fractional shortening: *0.14 >= 0.29 left ventricle - ejection fraction: 35% to 40% >= 55% aorta - annulus: 2.3 cm <= 3.0 cm aorta - sinus level: 2.6 cm <= 3.6 cm aortic valve - peak velocity: *2.4 m/sec <= 2.0 m/sec aortic valve - peak gradient: *54 mm hg < 20 mm hg aortic valve - mean gradient: 29 mm hg aortic valve - valve area: *0.7 cm2 >= 3.0 cm2 findings left atrium: mild la enlargement. no spontaneous echo contrast or thrombus in the body of the laa. all four pulmonary veins not identified. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. mild symmetric lvh. top normal/borderline dilated lv cavity size. moderately depressed lvef. right ventricle: mildly dilated rv cavity. borderline normal rv systolic function. aorta: normal ascending aorta diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: bioprosthetic aortic valve prosthesis (avr). avr leaflets move normally. severe as (aova <0.8cm2). mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. no ms. trivial mr. tricuspid valve: normal tricuspid valve leaflets. mild 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. conclusions pre-bypass: the left atrium is mildly dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is top normal/borderline dilated. overall left ventricular systolic function is moderately depressed (lvef= 35-40%). the right ventricular cavity is mildly dilated with borderline normal free wall function. there are simple atheroma in the descending thoracic aorta. a bioprosthetic aortic valve prosthesis is present. the aortic valve prosthesis leaflets appear to move normally. there is severe aortic valve stenosis (area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. post: prosthetic valve in aortic position. well seated and mechanically stable. no appreciable gradient. improved biventricular systolci function brief hospital course: on he underwent redo-sternotomy and avr. he was transferred to the icu in stable condition on epi, neo and propofol. he was extubated the morning of pod #1 secondary to agitation. he was started on coumadin for his mechanical valve. he was transferred to the floor on pod #1. his white count remained elevated and he was pancultured and started on azithromycin for ? of bronchitis/pneumonia. he became confused and on a code purple was called. he was started on ativan. neurology was called and a head ct which showed nothing acute was obtained. he was started on iv thiamine. he continued to be confused at times and on overnight another code purple was called. a psychiatry consult was called, ativan was tapered and haldol was started. he began to clear, and was weaned from his haldol. he awaited placement, and was ready for discharge home on pod #14. spoke with dr. office who has agreed to manage his coumadin. medications on admission: inderal 10", zantac 150", asa 81', lipitor 40', lexapro 20', mvi, folic acid 1' discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. 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* 4. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. escitalopram 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. hexavitamin tablet sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 8. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. warfarin 1 mg tablet sig: three (3) tablet po daily (daily) for 2 days: check inr with results to dr. . disp:*100 tablet(s)* refills:*0* 10. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 11. furosemide 40 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 5 days. disp:*10 tablet(s)* refills:*0* 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po bid (2 times a day) for 5 days. disp:*20 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: prosthetic aortic valve stenosis now s/p redo-redo avr chronic systolic heart failure bicuspid avr/avr /redo , depression, essential tremor, venous angio av malformation, abdm lymphoma, avascular necrosis-hips, traumatic splenectomy, herniography, r thumb , acl repair discharge condition: stable. discharge instructions: call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day of five in one week. shower, no baths, no lotions, creams or powders to incisions. no lifting more than 10 pounds or driving until follow up with surgeon. followup instructions: dr. 2 weeks dr. 4 weeks dr. 2 weeks procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: congestive heart failure, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status other complications due to heart valve prosthesis aortic valve disorders chronic systolic heart failure surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation delirium due to conditions classified elsewhere bronchitis, not specified as acute or chronic other diseases of mediastinum, not elsewhere classified essential and other specified forms of tremor other malignant lymphomas, intra-abdominal lymph nodes alcohol abuse, episodic 

Answer: The patient is high likely exposed to