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: sulfa (sulfonamide antibiotics) / penicillins attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: - coronary artery bypass grafting to one vessel (left internal mammary artery to left anterior descending artery)/aortic valve replacement (23mm st. epic porcine) history of present illness: 83 year old male with a history of aortic stenosis, now with a peak gradient of 90 mmhg, a mean of 57 mm hg, and of 0.7cm2 by recent echo. he has been fairly asymptomatic with regards to his aortic stenosis. his wife recently noted some exertional dyspnea and bilateral lower extremity. he was referred for a cardiac catheterization and was found to have lad disease and severe aortic stenosis. he is admitted today for heparin bridge, plan for cabg/avr in am. past medical history: hypertension hyperlipidemia aortic stenosis atrial fibrillation chronic renal insufficiency (baseline diastolic heart failure gerd complete heart block s/p pacemaker implant cholelithiasis colon polyps s/p resection mild copd s/p recent uri improved with short course of steriods/advair (2 months ago) pna hyperkalemia anemia gout osteoarthritis in bilateral knees hoh does not wear hearing aides social history: lives with wife; quit smoking >30 years ago, 30pack-yr hx, occasional etoh use, used to work in the meat business for stop and shop family history: there is no family history of premature coronary artery disease or sudden death. physical exam: pulse:60 resp:18 o2 sat:98/ra b/p right:133/52 left:134/59 height:5'7" weight:168 lbs general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right: palp left: palp dp right: palp left: palp pt : palp left: palp radial right: palp left: palp carotid bruit right: none left: none pertinent results: echo 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. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. there is moderate symmetric left ventricular hypertrophy. regional left ventricular wall motion is normal. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricular cavity is moderately dilated with mild global free wall hypokinesis. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque to xx cm from the incisors. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate thickening of the mitral valve chordae. mild (1+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is no pericardial effusion. post cpb: 1. preserved -ventricular systolci function with background inotropic support. 2. bioprosthetic valve in aortic position, well seated and stable with good leaflet excursion. no ai and minimal grqadient across the prosthesis. 3. trace mr d tricuspid regurgitation . ct scan: severe calcification of the aortic valve. moderate hiatal hernia. evidence of prior granulomatous infection. renal cyst. mild emphysema. cxr: frontal and lateral chest radiographs: a left-sided pacemaker generator pack projects leads into the right atrium and ventricle. the patient is status post median sternotomy. again seen is severe left lower lobe atelectasis, slightly worse since . an adjacent small left pleural effusion is also increased in size. the remaining lungs appear well aerated. there has been interval removal of a right ij central venous catheter. there is no pneumothorax. impression: slightly worsened left lower lobe collapse. slightly increased small left pleural effusion. 202/22/12 03:45pm blood wbc-7.5 rbc-3.75* hgb-12.3* hct-36.5* mcv-97 mch-32.8* mchc-33.7 rdw-15.8* plt ct-171 09:10am blood wbc-6.3 rbc-2.72* hgb-8.7* hct-25.7* mcv-94 mch-32.1* mchc-34.0 rdw-16.2* plt ct-72* 03:45pm blood pt-11.1 ptt-19.5* inr(pt)-1.0 09:10am blood pt-15.6* inr(pt)-1.5* 03:45pm blood glucose-79 urean-32* creat-1.1 na-140 k-4.9 cl-103 hco3-30 angap-12 04:15am blood glucose-92 urean-26* creat-1.4* na-140 k-3.8 cl-98 hco3-33* angap-13 03:45pm blood alt-19 ast-24 ld(ldh)-250 alkphos-58 amylase-91 totbili-0.8 02:04am blood calcium-8.5 phos-4.0 mg-2.7* 04:15am blood mg-2.5 09:10am blood wbc-6.3 rbc-2.72* hgb-8.7* hct-25.7* mcv-94 mch-32.1* mchc-34.0 rdw-16.2* plt ct-72* 09:10am blood plt ct-72* 04:15am blood glucose-92 urean-26* creat-1.4* na-140 k-3.8 cl-98 hco3-33* angap-13 brief hospital course: mr. was admitted to the on for surgical management of his aortic valve and coronary artery disease. heparin was started as he had been off his coumadin for five days in anticipation of surgery. a ct scan was performed which showed severe calcification of the aortic valve a moderate hiatal hernia, evidence of prior granulomatous infection, a renal cyst and mild emphysema. on , mr. was taken to the operating room where he underwent coronary artery bypass grafting lima to lad and an aortic valve replacement using a 23mm st. epic porcine valve. please see operative note for details. postoperatively he was taken to the intensive care unit for monitoring. over the next several hours, he awoke neurologically intact and was extubated. ep service consulted on patient for ppm interrogation. on post-op day one he was started on beta-blockers and diuretics and was diuresed towards his pre-op weight. later on this day he was transferred to the floor for further care. chest tubes and epicardial pacing wires were removed per protocol. coumadin was started for his atrial fibrillation and titrated for goal inr of .5. renal function bumped slightly to 1.4 and lasix was changed to pre-op dose of po lasix from iv with good results. electrolytes repleted as needed. his cxr showed lll collapse and he required cpt and pulmonary toileting with good effect. he continued to make good progress while working with physical therapy for strength and mobility. on post-op day #5 he was discharged to health care with the appropriate medications and follow-up appointments. medications on admission: allopurinol 100 mg furosemide 40 mg alternating with 1/2 tabs, daily - no substitution hydralazine 25 mg tid lopressor 100 mg warfarin 5 mg tablet- 1 tablet by mouth once a day zocor 10mg daily discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(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. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 4. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours). 6. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 7. symbicort 160-4.5 mcg/actuation hfa aerosol inhaler sig: one (1) inhalation (2 times a day). 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain/fever. 10. coumadin 5 mg tablet sig: one (1) tablet po once a day: titrate for goal inr of .5. disp:*30 tablet(s)* refills:*2* 11. lasix 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 12. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: tba discharge diagnosis: aortic stenosis s/p aortic valve replacement coronary artery disease s/p coronary artery bypass graft past history: hypertension hyperlipidemia atrial fibrillation chronic renal insufficiency (baseline diastolic heart failure gerd complete heart block s/p pacemaker implant cholelithiasis colon polyps s/p resection mild copd s/p recent uri improved with short course of steriods/advair (2 months ago) pna hyperkalemia anemia gout osteoarthritis in bilateral knees hoh does not wear hearing aides discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage edema right 2+ edema, left leg 1+ discharge instructions: 1) please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr. on @1:15 cardiologist/pcp: . on @1:30pm **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication atrial fibrillation goal inr 2.0-2.5 first draw: results to phone fax: pcp . (f) procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortic valve disorders personal history of tobacco use chronic kidney disease, unspecified pulmonary collapse other and unspecified hyperlipidemia long-term (current) use of anticoagulants cardiac pacemaker in situ chronic diastolic heart failure osteoarthrosis, localized, not specified whether primary or secondary, lower leg 

Answer: The patient is high likely exposed to