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: oxacillin / ciprofloxacin attending: chief complaint: chest pain/dyspnea on exertion major surgical or invasive procedure: cardiac cath aortic valve replacement with 23mm st. regent mechanical valve history of present illness: 66-year-old male with aortic stenosis, atrial fibrillation, coronary artery disease and type ii diabetes who was admitted for cardiac catheterization following an abnormal stress test. he had been doing well until at which time he developed chest burning and dypnea on exertion. he was admitted and underwent nuclear stress test on where he was able to exercise 6 minutes on protocol and stopped due to fatigue. nuclear images revealed a new partially reversible inferolateral wall perfusion defect and a fixed inferior wall defect. he was referred for cardiac catheterization. in the cath lab he was found to have single vessel coronary disease as previously but his aortic valve area was 0.68 cm2. he is being admitted for aortic valve replacement. past medical history: aortic stenosis, diabetes mellitus, atrial fibrillation, chronic diastolic heart failure, chronic kidney disease, chronic back pain, gout, s/p tonsillectomy social history: he is married and works as a french and spanish teacher in a high school. he does not smoke or drink. he has two daughters. family history: his mother had cabg @ age 80. father died of lung ca (smoker). htn and dm in family. physical exam: t: 97.9 bp: 117/73 hr: 83 rr: 18 o2: 97% on ra general: well appearing male, no acute distress heent: sclera anicteric, mmm, oropharynx clear cv: rrr, s1 + s2, ii/vi sem radiating throughout resp: clear to ausculation bilaterally, no wheezes, rales, ronchi gi: obese, soft, non-tender, non-distended, +bs gu: no foley ext: wwp, 2+ pulses, no clubbing, cyanosis or edema skin: no rashes pulses: dp and pt pulses palpable bilaterally pertinent results: ecg (): atrial fibrillation at a rate of 82. st-t wave abnormalities. cardiac catheterization (): 1. selective coronary angiography of this right dominant system demonstrated single vessel coronary artery disease. the left main demonstrated no angiographically apparent flow limiting disease. the left anterior descending artery demonstrated mild diffuse disease throughout without any significant stenosis. the left circumflex demonstrated a totally occluded obtuse marginal filling via right to left collaterals. the right coronary artery demonstrated no angiographically apparent disease. 2. lv ventriculography was deferred. 3. limited resting hemodynamics demonstrated normal right (rvedp 7 mm hg) and left (lvedp 7 mm hg) heart filling pressures. the cardiac index calculated via the fick method was preserved at 2.0 l/min/m2. 4. the mean pressure gradient across the aortic valve was 47 mm hg and a peak of 60 mm hg. the calculated aortic valve area of 0.68 cm2. the aortic valve was heavily calcified. echo (): pre-bypass: 1. the left atrium is dilated. mild spontaneous echo contrast is seen in the body of the left atrium. the left atrial appendage emptying velocity is depressed (<0.2m/s). 2. the right atrium is dilated. no atrial septal defect is seen by 2d or color doppler. 3. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is lateral wall hypokinesis of the mid to the apical segments ). overall left ventricular systolic function is mildly depressed (lvef= 45 %). 4. right ventricular chamber size and free wall motion are normal. 5. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 6. the aortic valve leaflets are moderately thickened. there is severe aortic valve stenosis (area <0.8cm2). mild (1+) aortic regurgitation is seen. 7. the mitral valve leaflets are moderately thickened. mild (1+) mitral regurgitation is seen. due to co-existing aortic regurgitation, the pressure half-time estimate of mitral valve area may be an overestimation of true mitral valve area. 8. there is no pericardial effusion. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine and is being av paced. 1. a well-seated bileaflet valve is seen in the aortic position with normal leaflet motion and gradients (mean gradient = 15 mmhg). no aortic regurgitation is seen. 2. left ventricular systolic function is low normal (lvef 45%). 3. right ventricular systolic function is normal. 4. aortic contours are intact post decannulation. brief hospital course: as mentioned in the hpi mr. was admitted following his cardiac cath which revealed aortic stenosis and single vessel coronary artery disease. he received medical management for several days and underwent pre-operative work-up while awaiting for surgery. on he was brought to the operating where he underwent a aortic valve replacement. please see operative report 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-operative day one his chest tubes were removed. he was started on beta blockers and diuretics and gently diuresed towards his pre-op weight. also on this day he was started on coumadin with heparin bridge for mechanical valve. coumadin was titrated. on post-op day two his epicardial pacing wires were removed and his was transferred to the telemetry floor for further care. cleared for discharge to rehab on pod #11 target inr is 2.5-3.0 for mechanical valve. inr in uptrend on dc 2.1. medications on admission: medications at home: niacin 1000 mg daily, kcl 10 meq , lasix 80 mg 1-2 tabs daily prn, zocor 20 mg 1 tab daily, coumadin 2.5 mg 1 tab for 6 days and 3.75 every saturday ld , ativan 1 mg qhs prn, xanax 0.25 mg prn, aldactone 25 mg daily, asa 81 mg, 2 tablets daily, lisinopril 10 mg daily, metoprolol tartrate 100 mg , nitroglycerin 0.4 mg 1 tab sl q 5 min prn chest pain, novolog 70/30 40 units , magnesium oxide 400 mg daily discharge medications: 1. 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* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 6. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. niacin 500 mg capsule, sustained release sig: two (2) capsule, sustained release po daily (daily). disp:*60 capsule, sustained release(s)* refills:*2* 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 7 days: 7 days. 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 10. warfarin 1 mg tablet sig: three (3) tablet po once (once): goal is 2.5 - 3. 11. insulin insulin sc fixed dose orders breakfast dinner 70 / 30 40 units 70 / 30 40 units insulin sc sliding scale breakfast lunch dinner bedtime humalog humalog humalog humalog glucose insulin dose insulin dose insulin dose insulin dose 0-60 mg/dl 4 oz. juice and 15 gm crackers 4 oz. juice and 15 gm crackers 4 oz. juice and 15 gm crackers 4 oz. juice and 15 gm crackers 61-120 mg/dl 0 units 0 units 0 units 0 units 121-140 mg/dl 2 units 2 units 2 units 0 units 141-200 mg/dl 4 units 4 units 4 units 2 units 201-240 mg/dl 6 units 6 units 6 units 4 units 241-280 mg/dl 8 units 8 units 8 units 6 units 12. colchicine 0.6 mg tablet sig: one (1) tablet po bid (2 times a day): until gouty flare up resolves then dc. 13. lasix 20 mg tablet sig: one (1) tablet po twice a day for 7 days. 14. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. discharge disposition: extended care facility: life care center of discharge diagnosis: aortic stenosis s/p aortic valve replacement pmh: diabetes mellitus, atrial fibrillation, chronic diastolic heart failure, chronic kidney disease, chronic back pain, gout, s/p tonsillectomy discharge condition: good discharge instructions: call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. shower daily, no baths, no lotions, creams or powders to incisions. no lifting more than 10 pounds for 10 weeks. no driving until follow up with surgeon. dr. will be following your inr and adjusting your coumadin for a goal inr of 2.5-3 when you are discharged from rehab. followup instructions: dr. in 4 weeks dr. in weeks dr. in weeks dr. will be following your inr and adjusting your coumadin for a goal inr of 2.5-3. rehab: please contact dr. prior to his discharge from rehab. daily inrs while at rehab. procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters intraoperative cardiac pacemaker diagnostic ultrasound of heart open and other replacement of aortic valve arthrocentesis diagnoses: other iatrogenic hypotension other chronic pain coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortic valve disorders peripheral vascular disease, unspecified other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) other and unspecified angina pectoris morbid obesity long-term (current) use of anticoagulants ventricular fibrillation other postprocedural status lumbago chronic diastolic heart failure olecranon bursitis enthesopathy of knee, unspecified gout with other specified manifestations 

Answer: The patient is high likely exposed to