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: shortness of breath major surgical or invasive procedure: mitral valve replacement utilizing a 33 millimeter ce perimount mitral bioprosthetic valve history of present illness: this is an 82 year old male with known mitral regurgitation and dilated cardiomyopathy. he also suffers from chronic atrial fibrillation. he complains of worsening fatigue and shortness of breath. cardiac catheterization in confirmed 3+ mitral regurgitation and an lvef of 35%. coronary angiography showed no flow limiting disease. his most recent echo was from which revealed moderate to severe mitral regurgitation, 1+ aortic insufficiency, and an lvef of 45%. based on the above results, he was referred for cardiac surgical intervention. he will be admitted for reversal of warfarin and heparinization. past medical history: mitral regurgitation, dilated cardiomyopathy, congestive heart failure, history of myocardial infarction, chronic atrial fibrillation, hyperlipidemia, history of cerebrovascular accident, trigeminal neuralgia, testicular tumor - s/p orchiectomy, s/p right shoulder surgery social history: lives with wife. retired chief probation officer. denies tobacco. occasional etoh - averges out to one drink a day. family history: no premature cad. brother and mother died of mi in their 70's. physical exam: vitals: t 98.7, bp 139/72, hr 66, rr 16, sat 100% on room air general: elderly male in no acute distress heent: oropharynx benign, sclera anicteric, perrl, eomi neck: supple, no jvd, no carotid bruits heart: irregular rate, normal s1s2, systolic murmur noted lungs: clear bilaterally abdomen: soft, nontender, normoactive bowel sounds ext: warm, 1+ edema, chronic venous stasis changes, no varicosities pulses: 1+ distally neuro: nonfocal pertinent results: 03:04pm blood wbc-6.1 rbc-3.75* hgb-12.6* hct-35.4* mcv-94 mch-33.6* mchc-35.6* rdw-13.5 plt ct-148* 03:04pm blood pt-15.1* ptt-24.6 inr(pt)-1.4* 03:04pm blood glucose-88 urean-23* creat-1.1 na-142 k-4.2 cl-107 hco3-25 angap-14 03:04pm blood alt-20 ast-25 alkphos-103 amylase-57 totbili-0.6 06:30am blood wbc-7.3 rbc-3.10* hgb-10.0* hct-30.3* mcv-98 mch-32.3* mchc-33.1 rdw-14.2 plt ct-135* 09:30am blood pt-21.1* inr(pt)-2.0* 06:35am blood urean-39* creat-1.7* 06:30am blood glucose-103 urean-39* creat-1.9* na-138 k-4.8 cl-104 hco3-25 angap-14 03:23am blood glucose-109* urean-34* creat-1.8* na-135 k-4.2 cl-103 hco3-23 angap-13 04:51am blood glucose-108* urean-33* creat-2.0* na-134 k-4.2 cl-102 hco3-24 angap-12 brief hospital course: mr. was admitted and underwent routine preoperative evaluation. he was concomitantly heparinized for his chronic atrial fibrillation. workup was otherwise unremarkable and he was cleared for surgery. on , dr. performed a mitral valve replacement utilizing a 33 millimeter ce perimount mitral bioprosthetic valve. the operation was uneventful and he transferred to the csru in stable condition. within 24 hours, he awoke neurologically intact and was extubated. he initially required atrial pacing for an underlying junctional rhythm. he otherwise maintained stable hemodynamics and successfully weaned from inotropic support. over several days, his native heart rate improved and low dose beta blockade was resumed. given his bradycardia and long standing history of atrial fibrillation, amiodarone was not recommended. he was noted to have a slight decline in renal function but continued to maintain adequate urine output. his creatinine peaked to 2.0 on postoperative day four. diuretics were titrated accordingly. his csru course was otherwise uneventful and he transferred to the sdu on postoperative day five. his renal function continued to improve. warfarin was dosed daily for a goal inr between . he transiently required heparin for a subtherapeutic prothrombin time. over several days, he continued to make clinical improvements and made steady progress the physical therapy. he was cleared for discharge to rehab on postoperative day 7. all surgical wounds were clean without signs of infection. his creatinine continued to improve, and was 1.7 on the day of discharge.inr on was 2.0 after several doses of 5 milligrams. medications on admission: lipitor 20 qd, lasix 20 qd, warfarin 5 qd, kcl, aspirin 81 qd, toprol xl 12.5 qd discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. warfarin 5 mg tablet sig: five (5) tablet po once (once) for 1 doses: check inr and prn and redose coumadin, . 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. lasix 20 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: on - discharge diagnosis: mitral regurgitation - s/p mvr, dilated cardiomyopathy, postoperative acute renal insufficiency, congestive heart failure, chronic atrial fibrillation, hyperlipidemia, history of cerebrovascular accident, trigeminal neuralgia, testicular tumor - s/p orchiectomy, s/p right shoulder surgery discharge condition: good good discharge instructions: patient may shower, no baths. no creams, lotions or ointments to incisions. no driving for at least one month. no lifting more than 10 lbs for at least 10 weeks from the date of surgery. monitor wounds for signs of infection. please call with any concerns or questions. patient may shower, no baths. no creams, lotions or ointments to incisions. no driving for at least one month. no lifting more than 10 lbs for at least 10 weeks from the date of surgery. monitor wounds for signs of infection. please call with any concerns or questions. weigh daily, call with weight gain 2 pounds in one day or five in one week. followup instructions: cardiac surgeon, dr. in weeks - call for appt. local pcp, . in weeks - call for appt. local cardiologist, dr. in weeks - call for appt. cardiac surgeon, dr. in weeks - call for appt. local pcp, . in weeks - call for appt. local cardiologist, dr. in weeks - call for appt. procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft diagnoses: other primary cardiomyopathies mitral valve disorders congestive heart failure, unspecified atrial fibrillation unspecified disorder of kidney and ureter 

Answer: The patient is high likely exposed to