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: chest pain/doe/fatigue major surgical or invasive procedure: - aortic valve replacement (21mm onyx mechanical valve) history of present illness: 42 yo m with well known history of a bicuspid aortic valve followed by serial echos, with recent increase in chest pain and doe. recent echo showed moderate to severe as with severe ai. he has now been referred for surgical management. past medical history: bicuspid av/severe as now s/p avr lipids, obesity, glucose intolerance, htn, knee surgery x 4 on right, shoulder surgery - rotator cuff x 2 left social history: works as truck driver remote tobacco use occasional etoh family history: brother deceased from ?mi at age 30 physical exam: admission hr 70 rr 12 bp 112/66 wdwn m in nad lungs ctab heart rrr 3/6 systolic murmur, distaolic murmur abdomen obese, soft, nt extrem warm, no edema, 2+ pp carotids with ? transmitted murmurs vs. bruit discahrge 99.1 92sr 110/58 18 97% ra gen: nad pulm: cta bilat cv rrr, s1-s2 w/sharp click. sternum stable, incision cdi. abdm: soft, nt/nd/+bs ext: warm, well perfused. trace pedal edema pertinent results: basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 10:25am 21.9* 80.4* 2.1* blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 07:10am 5.3 3.96* 11.2* 33.1* 84 28.2 33.8 14.1 307 echocardiography report , (complete) done at 11:13:33 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 42 m hgt (in): 67 bp (mm hg): 120/65 wgt (lb): 262 hr (bpm): 90 bsa (m2): 2.27 m2 indication: intraop avr ? aortic root icd-9 codes: 440.0, 424.1 test information date/time: at 11:13 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 #: 2007aw2-: machine: 2 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.8 cm <= 4.0 cm left atrium - four chamber length: 5.0 cm <= 5.2 cm left atrium - peak pulm vein s: 0.5 m/s left atrium - peak pulm vein d: 0.4 m/s left atrium - peak pulm vein a: 0.1 m/s < 0.4 m/s left ventricle - septal wall thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.3 cm <= 5.6 cm left ventricle - systolic dimension: 2.1 cm left ventricle - fractional shortening: 0.51 >= 0.29 left ventricle - ejection fraction: 55% to 60% >= 55% left ventricle - peak resting lvot gradient: 9 mm hg <= 10 mm hg aorta - annulus: 2.2 cm <= 3.0 cm aorta - sinus level: 3.6 cm <= 3.6 cm aorta - sinotubular ridge: 2.8 cm <= 3.0 cm aorta - ascending: *3.5 cm <= 3.4 cm aorta - descending thoracic: 2.2 cm <= 2.5 cm aortic valve - peak velocity: *3.1 m/sec <= 2.0 m/sec aortic valve - peak gradient: *40 mm hg < 20 mm hg aortic valve - mean gradient: 23 mm hg aortic valve - lvot pk vel: 1.50 m/sec aortic valve - lvot vti: 30 aortic valve - lvot diam: 2.2 cm aortic valve - valve area: *1.7 cm2 >= 3.0 cm2 mitral valve - peak velocity: 1.1 m/sec mitral valve - mean gradient: 2 mm hg mitral valve - e wave: 1.1 m/sec mitral valve - a wave: 0.7 m/sec mitral valve - e/a ratio: 1.57 mitral valve - e wave deceleration time: *130 ms 140-250 ms findings left atrium: mild la enlargement. no mass/thrombus in the laa. right atrium/interatrial septum: normal interatrial septum. no asd by 2d or color doppler. left ventricle: mild symmetric lvh. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. mildly dilated ascending aorta. normal aortic arch diameter. normal descending aorta diameter. aortic valve: bicuspid aortic valve. moderately thickened aortic valve leaflets. mild as (aova 1.2-1.9cm2). severe (4+) ar. eccentric ar jet. mitral valve: normal mitral valve leaflets with trivial mr. s. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. no 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 patient was under general anesthesia throughout the procedure. no tee related complications. the patient appears to be in sinus rhythm. conclusions pre bypass: the left atrium is mildly dilated. no mass/thrombus is seen in the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic arch is poorly seen. the aortic valve is bicuspid. the aortic valve leaflets are moderately thickened, with servere focal calicification at the commisures. there is mild aortic valve stenosis (area 1.2-1.9cm2). severe (4+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric. the mitral valve appears structurally normal with trivial mitral regurgitation. post bypass: patient is in sinus rhythm, requiring no ionotropes. perserved biventricular funciton lvef >55%. there is a mechanical aortic valve prosthesis in situ. peak gradients 27-19 mm hg, mean 4 mm hg. there is a small paravalvular leak at interface with anterior leaflet of mitral valve (seen best on mid esophageal av short axis view). aortic contours intact. remaining exam is unchanged. all findings discussed with surgeons at the time of the exam. brief hospital course: he was taken to the operating room on where he underwent an avr with #21 on-x mechanical valve. he was transferred to the icu in critical but stable condition. he was remained hemodynamically stable and extubtaed on the operative day. he was transferred to the floor on pod #1. his activity level was advanced and he was started on coumadin for his mechanical valve. he did well postoperatively and remained in the hospital on iv heparin awaiting a therapeutic inr. on pod 7 his inr was 2.1 and he was discharged home, to f/u w/dr in 4 weeks. his inr and coumadin dosing are to be followed by dr . medications on admission: asa, protonix, lipitor, lotrel, lasix 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. 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* 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 5. hydromorphone 2 mg tablet sig: one (1) tablet po q2h (every 2 hours) as needed. disp:*50 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 7. potassium chloride 10 meq tablet sustained release sig: two (2) capsule, sustained release po once a day for 1 weeks. disp:*14 capsule, sustained release(s)* refills:*0* 8. furosemide 20 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 9. warfarin 2 mg tablet sig: as directed tablet po once a day: pt to take 5 mg on and then as directed by dr . disp:*90 tablet(s)* refills:*2* 10. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: bicuspid av/severe ai s/p avr (onyx) hyperlipidemia htn glucose intolerance obesity discharge condition: good. discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month. 7) call with any questions or concerns. 8) coumadin for mechanical aortic valve - check inr results to dr. @ . goal inr 2.5-3. followup instructions: provider: , follow-up appointment should be in 1 month follow-up with dr. in weeks. provider: , i follow-up appointment should be in 2 weeks call all providers for appointments. procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve cardioplegia diagnoses: unspecified essential hypertension aortic valve disorders other and unspecified hyperlipidemia obesity, unspecified congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to