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: no known allergies / adverse drug reactions attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: cardiac catheterization aortic valve replacement ( porcine aortic) mitral valve repair (28 mm annuloplasty ring) coronary artery bypass graft x3 (left internal mammary artery > left anterior descending, saphenous vein graft > diagonal, saphenous vein graft > posterior descending artery) history of present illness: this is a 66 year old male with history of aortic valve disease followed with serial echocardiograms. over the past several months he has noticed worsening of his exertional angina. his symptoms worsened when he was celebrating his sons engagement by eating more sodium then normal. he also has developed peripheral edema and pillow orthopnea. he denies syncope, presyncope, palpitations, pnd, fevers, chills and rigors. a recent echocardiogram from revealed progression of his aortic stenosis. given that finding and worsening symptoms, he has been referred for surgical evaluation. he is admitted today for catherization tomorrow/iv heparin bridge with plans for or on thurs for avr/?mvr/?cabg. past medical history: aortic stenosis and insufficiency mitral regurgitation chronic atrial fibrillation, history of unsuccessful cardioversion hypertension hypercholesterolemia obesity anxiety varicose veins s/p brain surgery age 13 after a fall s/p tonsillectomy s/p appendectomy s/p ventral hernia repair s/p cataract surgery social history: lives with: wife in occupation: musician cigarettes: smoked no yes last cigarette hx: 1ppd x 27 yrs etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: denies family history: father died of an mi at 32 and father's brother died of mi at age 40 physical exam: pulse:66 af resp:12 o2 sat: 98% room air b/p right: left:132/75 height: 5'9" weight: 195# general: aao x 3 in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade 4/6 sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: trace le edema varicosities: significant gsv varicosities noted bilaterally neuro: grossly intact pulses: femoral right: 2 left: 2 dp right: 1 left: 1 pt : 1 left: 1 radial right: 2 left: 2 carotid bruit: transmitted murmurs bilaterally pertinent results: intraop tee conclusions pre-bypass: -no spontaneous echo contrast or thrombus is seen in the body of the right atrium or the right atrial appendage. -the left ventricle is not well seen. there is mild regional left ventricular systolic dysfunction with inferior wall hypokinesis. -there are simple atheroma in the descending thoracic aorta. -there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). moderate (2+) aortic regurgitation is seen. -the mitral valve leaflets are moderately thickened. moderate to severe (3+) mitral regurgitation is seen. -due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). dr. was immediately notified of the result. postbypass the patient is receiving epinephrine at 0.03 ucg/kg/min lv systolic function is moderately impaired. the inferior wall and inferior septum are dyskinetic. lvef 30-35% rv systolic functiom is normal. there is a well seated, well functioning bioprosthesis in the aortic position. no ai is visualized. there is a ring prosthesis in the mitral position. the mr is now trace. the remaining exam is unchanged from prebypass 05:25am blood wbc-7.9 rbc-2.80* hgb-9.0* hct-25.7* mcv-92 mch-32.2* mchc-35.1* rdw-14.8 plt ct-199 06:15am blood wbc-10.1 rbc-2.87* hgb-9.6* hct-26.2* mcv-91 mch-33.4* mchc-36.5* rdw-14.6 plt ct-174 06:20am blood wbc-12.1* rbc-2.49* hgb-8.3* hct-23.2* mcv-93 mch-33.1* mchc-35.7* rdw-13.7 plt ct-128* 05:25am blood pt-21.5* inr(pt)-2.0* 06:15am blood pt-17.6* inr(pt)-1.6* 06:20am blood pt-14.9* inr(pt)-1.3* 05:18am blood pt-13.5* ptt-21.2* inr(pt)-1.2* 03:26am blood pt-14.5* ptt-31.1 inr(pt)-1.2* 01:43pm blood pt-16.2* ptt-36.3* inr(pt)-1.4* 12:26pm blood pt-17.5* ptt-36.3* inr(pt)-1.6* 06:45am blood pt-13.8* ptt-53.0* inr(pt)-1.2* 05:25am blood urean-22* creat-0.8 na-134 k-3.8 cl-96 06:15am blood glucose-107* urean-22* creat-0.9 na-132* k-4.7 cl-96 hco3-30 angap-11 06:20am blood glucose-136* urean-21* creat-0.7 na-129* k-4.4 cl-94* hco3-28 angap-11 05:18am blood glucose-134* urean-16 creat-0.8 na-132* k-5.0 cl-101 hco3-24 angap-12 brief hospital course: admitted preoperative for heparin bridge from coumadin for atrial fibrillation. he underwent preoperative workup that included cardiac catheterization on which revealed coronary artery disease. on he was brought to the operating room for aortic valve replacement, mitral valve repair and coronary artery bypass graft surgery. see operative report for further details. he was transferred to the intensive care unit for post operative management.he was extubated later that day and transferred to the floor on pod #2 to begin increasing his activity level. chest tubes and pacing wires removed per protocol. he was gently diuresed toward his preop weight and beta blockade was titrated. coumadin restarted for chronic a fib. continued to make good progress and was cleared for discharge to home with vna on pod #5. target inr 2.0-2.5. first inr check tomorrow with vna. all f/u appts were advised. he does have 2+ edema of the lower extremities, and some serous drainage from evh sites. he is advised to cover these with dsd until it stops. medications on admission: warfarin 4 mg tablet daily q mon wed fri and 5mg tues thurs sat sun - last dose nifedipine 60mg daily atenolol 100mg daily lisinopril 20mg daily crestor 20mg daily aspirin 81mg daily discharge medications: 1. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*1* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(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:*1* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 weeks. disp:*28 tablet(s)* refills:*0* 5. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 6. rosuvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 7. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 8. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 9. warfarin 1 mg tablet sig: five (5) tablet po daily (daily): 5 mg dose today only;all further dosing by clinic;target inr 2.0-2.5 for chronic a fib. disp:*40 tablet(s)* refills:*1* 10. furosemide 40 mg tablet sig: one (1) tablet po twice a day for 10 days. disp:*20 tablet(s)* refills:*0* 11. potassium chloride 20 meq packet sig: one (1) packet po q12h (every 12 hours) for 10 days. disp:*20 packet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: aortic stenosis and insufficiency s/p avr mitral regurgitation s/p mv repair chronic atrial fibrillation coronary artery disease s/p cabg hypertension hypercholesterolemia obesity anxiety varicose veins discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage leg-healing well, no erythema, slight serosanguinous drainage from evh sites edema- 2+ discharge instructions: 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 please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks 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** labs: pt/inr for coumadin ?????? indication chronic afib goal inr 2.0-2.5 first draw results to: clinic fax phone / followup instructions: you are scheduled for the following appointments surgeon: dr. phone: date/time: 1:15 in the medical office building wound check date/time:thursday @ 10:15 am in the medical office building cardiologist:dr. (her office will call you with appt in weeks) please call to schedule appointments with your primary care dr. in weeks **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 chronic afib goal inr 2.0-2.5 first draw results to: clinic fax phone / procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries open and other replacement of aortic valve with tissue graft annuloplasty diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension hyposmolality and/or hyponatremia atrial fibrillation personal history of tobacco use anxiety state, unspecified other and unspecified angina pectoris mitral valve insufficiency and aortic valve stenosis obesity, unspecified examination of participant in clinical trial 

Answer: The patient is high likely exposed to