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: doe/ angina major surgical or invasive procedure: avr (23mm mosaic porcine) history of present illness: 71 yo male who fractured 4 ribs in when he fell off a ladder. shortly thereafter, he began to notice sob. he has had progressive doe since then and an echo showed severe as. referred for surgical eval. past medical history: aortic stenosis osteoarthritis bil. hands 4 right rib fxs etoh abuse ventral hernia ? rheumatic fever in childhood torn left with partial peripheral vision loss restless leg syndrome mild glucose elevation ( diet-controlled) psh: lumbar surgery x2 social history: works on golf course maintenance never smoked cigarettes, but uses a rare pipe drinks per day lives alone no recr. drugs family history: non-contrib. physical exam: 5'9" 162# hr 64 rr 12 150/80 nad skin unremarkable limited constriction of left pupil neck supple, full rom, murmur radiates to carotids ctab rrr 3/6 sem radiates to precordium and carotids soft, nt, nd, no hepatomegaly warm, well-perfused, no edema or varocosities noted neuro grossly intact, strengths throughout 2+ bil. fems/radials 1+ bil. dp/pts pertinent results: 10:22am blood wbc-25.1*# rbc-2.86*# hgb-9.6*# hct-27.7*# mcv-97 mch-33.5* mchc-34.5 rdw-13.4 plt ct-162 02:10am blood wbc-10.4 rbc-3.59* hgb-11.7* hct-33.9* mcv-94 mch-32.5* mchc-34.5 rdw-13.6 plt ct-221 10:22am blood pt-16.1* ptt-39.5* inr(pt)-1.4* 01:31am blood pt-16.9* ptt-28.8 inr(pt)-1.5* 02:18am blood glucose-87 urean-16 creat-1.0 na-139 k-4.6 cl-116* hco3-21* angap-7* 02:10am blood glucose-109* urean-25* creat-0.9 na-139 k-4.3 cl-103 hco3-28 angap-12 09:28am blood alt-24 ast-93* ld(ldh)-296* alkphos-48 amylase-37 totbili-0.8 05:40am blood wbc-8.3 rbc-3.72* hgb-11.8* hct-34.2* mcv-92 mch-31.7 mchc-34.4 rdw-13.4 plt ct-279 05:40am blood plt ct-279 05:40am blood pt-20.1* inr(pt)-1.9* 05:40am blood glucose-91 urean-20 creat-1.0 na-134 k-4.4 cl-97 hco3-25 angap-16 02:22am blood lipase-17 06:05am blood mg-1.9 01:31am blood ammonia-27 , m 72 radiology report chest (pa & lat) study date of 9:53 am clip # reason: eval for pleural effusions medical condition: 72 year old man s/p avr preliminary report !! pfi !! no significant change in small bilateral pleural effusions. heart size slightly decreased compared to and no evidence of failure or volume overload. dr. , m 72 radiology report renal u.s. port study date of 11:03 am reason: s/p avr eval for renal artery stenosis medical condition: 72 year old man with s/p avr reason for this examination: doppler r/o renal artery stenosis final report renal ultrasound: duplex imaging of both kidneys was performed. the right kidney measures 11.8 cm and demonstrates normal main renal artery and venous waveforms and flow. peak arterial flow in the right main renal artery is 80 cm/s. the resistive indices in the upper, mid and lower pole interlobar arteries are 0.74, 0.74 and 0.72, respectively. the left kidney measures 11.4 cm and demonstrates normal arterial and venous waveforms and flow. peak arterial flow is in the left main renal artery is 66 cm/s. the resistive indices of the left upper and mid interpolar arteries measure 0.75 and 0.71, respectively. the left lower pole interlobar artery waveforms are not clearly imaged. there is no evidence of hydronephrosis or mas bilaterally. there is minimal ascites in the lower abdomen. impression: 1. no evidence of renal artery stenosis or acute renal process. 2. minimal ascites. the study and the report were reviewed by the staff radiologist. dr. dr. echocardiography report , (complete) done referring physician information , r. age (years): 72 m hgt (in): 68 bp (mm hg): 132/66 wgt (lb): 162 hr (bpm): 68 bsa (m2): 1.87 m2 indication: aortic valve disease. left ventricular function. intraop tee for avr. icd-9 codes: 424.1 test information date/time: at 12:31 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 #: 2009aw0-: machine: siemens echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 45% to 50% >= 55% aorta - annulus: 2.4 cm <= 3.0 cm aorta - sinus level: 3.2 cm <= 3.6 cm aorta - sinotubular ridge: 2.7 cm <= 3.0 cm aorta - ascending: 3.0 cm <= 3.4 cm aorta - descending thoracic: 1.8 cm <= 2.5 cm aortic valve - lvot diam: 2.0 cm mitral valve - pressure half time: 100 ms mitral valve - mva (p t): 2.2 cm2 mitral valve - e wave: 0.7 m/sec mitral valve - a wave: 0.7 m/sec mitral valve - e/a ratio: 1.00 findings left atrium: mild spontaneous echo contrast in the body of the la. mild spontaneous echo contrast in the laa. no thrombus in the laa. left ventricle: mild symmetric lvh with normal cavity size. normal regional lv systolic function. mildly depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal diameter of aorta at the sinus, ascending and arch levels. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. bioprosthetic aortic valve prosthesis (avr). mechanical aortic valve prosthesis (avr). avr well seated, normal leaflet/disc motion and transvalvular gradients. critical as (area <0.8cm2). mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. moderate mitral annular calcification. calcified tips of papillary muscles. minimally increased gradient consistent with trivial ms. mild (1+) mr. tricuspid valve: physiologic tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. the patient appears to be in sinus the patient. see conclusions for post-bypass data the post-bypass study was performed while the patient was receiving vasoactive infusions (see conclusions for listing of medications). conclusions pre-bypass: 1. mild spontaneous echo contrast is seen in the body of the left atrium. 2. mild spontaneous echo contrast is present in the left atrial appendage. no thrombus is seen in the left atrial appendage. 3. there is mild symmetric left ventricular hypertrophy with normal cavity size. 4. regional left ventricular wall motion is normal. 5. overall left ventricular systolic function is mildly depressed (lvef= 50 %). 6. right ventricular chamber size and free wall motion are normal. 7. the diameters of aorta at the sinus, ascending and arch levels are normal. 8. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 9. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. 10. the mitral valve leaflets are mildly thickened. there is a minimally increased gradient consistent with trivial mitral stenosis. mild (1+) mitral regurgitation is seen. 11. there is no pericardial effusion. dr. was notified intraop and in person of the results on . post-bypass: 1. for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine. 2. regional and global left ventricular systolic function are normal. 3. a bioprosthetic aortic valve prosthesis is present. a mechanical aortic valve prosthesis is present. the aortic valve prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. no aortic regurgitation is seen. 4. aorta intact post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 12:54 brief hospital course: admitted and underwent surgery with a #23mm mosaic porcine aortic valve replacement with dr. . please refer to dr operative report for further details. cross clamp time= 48 minutes. cardiopulmonary bypass time=73minutes. mr. was transferred to the cvicu in stable condition on a propofol drip. he awoke neurologically intact and was extubated that evening.all lines and drains were discontinued in a timely fashion. he remained in the cvicu for blood pressure management and rhythm observation, as he went into a junctional rhythm with a 2.9 second pause on pod # 3. beta-blocker was discontinued and no statin was ever started due to his liver disease. over the next few postoperative days mr. became increasingly confused and agitated requiring sedation with ativan due to his alcoholic history, and to safegaurd his sternotomy. pod# 4 he went into a rapid atrial fibrillation. he was rate controlled with beta-blocker and an electrophysiology consult was made for recommendations regarding his rhythm and any possible need for a permanent pacemaker. he continued to progress, with his mental status returning to baseline, and on pod# 7 was transferred to the stepdown unit for further monitoring and progression. physical therapy was consulted. the remainder of his postoperative course was essentially uneventful and on pod#9 he was discharged to a rehab at lifecare center of for further improvement in strength, endurance, and activities of daily living. all follow up appointments are listed. medications on admission: requip 5 mg daily lanoxin 0.25 mg daily isosorbide 10 mg tid hydrocodone/apap 7.5mg discharge medications: 1. acebutolol 200 mg capsule sig: one (1) capsule po bid (2 times a day). 2. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 4. ropinirole 5 mg tablet sig: one (1) tablet po twice a day. 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. multivitamin tablet sig: one (1) tablet po daily (daily). 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 9. furosemide 20 mg tablet sig: one (1) tablet po once a day. 10. potassium chloride 10 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po once a day. 11. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 12. acetaminophen 325 mg tablet sig: 1-2 tablets po q8h (every 8 hours) as needed for pain. 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. warfarin 1 mg tablet sig: one (1) tablet po once a day: 1mg on then adjusted to target inr 2-2.5. discharge disposition: extended care facility: life care center of discharge diagnosis: aortic stenosis s/p avr (#23mm mosaic porcine) osteoarthritis bil. hands 4 right rib fxs etoh abuse ventral hernia ? rheumatic fever in childhood torn left with partial peripheral vision loss restless leg syndrome mild glucose elevation ( diet-controlled) hepatomegaly psh: lumbar surgery x2 discharge condition: good discharge instructions: no lotions, creams or powders on any incision. shower daily and pat incision dry. no baths or swimming. no driving for one month. no lifting greater than 10 pounds for 10 weeks. call for fever greater than 100.5, redness, drainage, or weight gain of 2 pounds in 2 days or 5 pounds in 1 week. followup instructions: see dr. in weeks see dr. in weeks see dr. in 4 weeks please call for all appts. procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart cardioplegia open and other replacement of aortic valve with tissue graft transfusion of packed cells diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled alcoholic cirrhosis of liver acute kidney failure, unspecified atrial fibrillation aortic valve disorders other and unspecified alcohol dependence, continuous alcohol withdrawal restless legs syndrome (rls) 

Answer: The patient is high likely exposed to