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 major surgical or invasive procedure: mvr (#29 mosaic porcine), tvrepair (#30 annuloplasty), bedside cystoscopy for foley placement history of present illness: 74 yo m with mr/ms s/p valvuloplasty with c/o fatigue for the past few months. past medical history: rhd, ms s/p valvuloplasty , afib, chf, lipids, htn, left inguinal hernia (unrepaired), tonsillectomy, s/p appy social history: retired from department of defense 20 pack year tob rare etoh family history: nc physical exam: hr 76 rr 16 bp 157/47 edentulous lungs ctab hsm abd benign pertinent results: cardiology report echo study date of interpretation: findings: left atrium: moderate la enlargement. mild spontaneous echo contrast in the body of the la. no mass/thrombus in the laa. right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. mildly dilated descending aorta. simple atheroma in descending aorta. aortic valve: mildly thickened aortic valve leaflets. no as. trace ar. mitral valve: severely thickened/deformed mitral valve leaflets. mild mitral annular calcification. severe ms (mva <1.0cm2). moderate to severe (3+) mr. eccentric mr jet. tricuspid valve: moderate to severe tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: trivial/physiologic pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. results were personally reviewed with the md caring for the patient. conclusions: prebypass: the left atrium is moderately dilated. mild spontaneous echo contrast is seen in the body of the left atrium. no mass/thrombus is seen in the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are severely thickened/deformed. there is severe mitral stenosis (area <1.0cm2). moderate to severe (3+) mitral regurgitation is seen. the mitral regurgitation jet is eccentric. moderate to severe tricuspid regurgitation is seen. there is a trivial/physiologic pericardial effusion. there is a small left pleural effusion. postbypass: the patient is in atrial fibrillation. biventricular function is preserved. the mitral valve is well seated with good leaflet excursion. there is no mr. the mean gradient across the mitral valve is 5 mm hg. there is trace tr after annuloplasty ring placement. 07:20am blood wbc-9.8 rbc-3.08* hgb-9.6* hct-28.1* mcv-91 mch-31.1 mchc-34.1 rdw-17.0* plt ct-470* 07:20am blood plt ct-470* 07:20am blood pt-21.8* inr(pt)-2.1* 09:55am blood pt-20.4* inr(pt)-2.0* 04:10am blood pt-22.4* ptt-33.8 inr(pt)-2.2* 07:20am blood glucose-96 urean-17 creat-0.8 na-137 k-4.4 cl-102 hco3-27 angap-12 brief hospital course: cardiac catheterization on showed coronary arteries are free of angiographically significant disease, and severe mitral mixed stenosis and regurgitation. surgery was planned for however was cancelled secondary to elevated inr. he was given vitamin k, and was taken to the operating room on where he underwent a mvr (porcine) and tvrepair. he was transferred to the icu in critical but stable condition. immediately postoperatively he was seen by urology for hematuria. cystoscopy was performed and a 14 french coude was placed which is to stay in place for 10-14 days with outpatient urology follow up. he was extubated on pod #1. he was transferred to the floor on pod #3. he was started on heparin and coumadin for atrial fibrillation as well as mitral replacement and tricuspid repair. chest tubes and pacing wires removed without incident. heparin continued until inr therapeutic. abx continued for coverage of cystoscopy instrumentation during surgery. hematuria continued periodically and he was followed closely by the urology team with continuous bladder irrigation. bladder irrigation was continued until his urine was clear and the was dc'd. the following day he was found to have suprapubic pain and overflow incontinence with fruit puch colored urine. a foley was unable to be inserted and cystoscopy was again performed and foley inserted with plans to keep the foley fastened at all times, no cbi or irrigation, starting flomax, and follow up as an outpatient in weeks. he should remain on cipro until the foley is discontinued. his coumadin will be followed by dr. as prior to surgery. medications on admission: digoxin 0.25 mg daily coumadin 2 mg daily toprol 12.5 mg crestor 40 mg daily uniretic 15/25 mg daily vitamin d ca discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 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:*0* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 5. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours): while foley in place. . disp:*30 tablet(s)* refills:*0* 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* 8. coumadin 2 mg tablet sig: one (1) tablet po at bedtime for 2 doses. disp:*60 tablet(s)* refills:*0* 9. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 10. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). disp:*30 capsule, sust. release 24 hr(s)* refills:*0* 11. uniretic 15-25 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: all care vna of greater discharge diagnosis: ms, rhd, tr s/p mitral valvuloplasty afib chf lipids htn left inguinal hernia, unrepaired tonsils appy 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, no baths, no lotions, creams or powders to incisions. no heavy lifting or driving until follow up with surgeon. followup instructions: dr. (pcp/cardiologist) 2 weeks and for coumadin dr. 4 weeks dr. (urologist) 10-14 days procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures arterial catheterization other cystoscopy annuloplasty open and other replacement of mitral valve with tissue graft transfusion of packed cells insertion of indwelling urinary catheter diagnoses: atrial fibrillation atrial flutter rheumatic heart failure (congestive) unspecified accident injury to bladder and urethra, without mention of open wound into cavity diseases of tricuspid valve inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent) mitral stenosis with insufficiency 

Answer: The patient is high likely exposed to