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: penicillins / amoxicillin attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement (#23 tissue) history of present illness: 67 year old female with known aortic stenosis which has been followed by serial echocardiograms for the past year. she has always been told she had a heart murmur however she did not start having surveillance echocardiograms until a year ago. over the past several months, she has noted worsening symptoms of dyspnea on exertion and well as progressive fatigue. her most recent echocardiogram has demonstrated worsening gradients across the aortic valve with concentric left ventricular hypertrophy. she has now been referred for aortic valve replacement surgery. past medical history: aortic stenosis hypertension hyperlipidemia depression history of left ankle cellulitis arthritis bilateral knee replacements d+c's cholecystectomy tubal ligation social history: lives with: husband in occupation: retired tobacco: denies etoh: denies family history: non-contributory physical exam: pulse: 70 sr resp: 16 o2 sat: b/p right: 110/80 left: 108/78 height: 62" weight: 156 general: wdwn in nad skin: warm, dry, intact. no c/c/e heent: perrla eomi ncat, sclera anicteric, op benign. teeth in good repair. neck: supple full rom chest: lungs clear bilaterally heart: rrr, nl s1-prominent s2. iv/vi highpitched systolic ejection murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused no edema varicosities: none neuro: grossly intact pulses: femoral right: 2 left: 2 dp right: 2 left: 2 pt : 2 left: 2 radial right: 2 left: 2 carotid bruit transmitted murmur bilaterally pertinent results: echo: post op the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. the mitral valve leaflets are structurally normal. no mitral regurgitation is seen. there is no pericardial effusion. post bypass: tissue aortic valve in good position with small paravalvuar leak near right coronary cusp which improved to tiny post protamine. peak gradient 23, mean 11 mm hg. mr remains mild. aortic contours intact. remaining exam is unchanged. all findings discused with surgeons at the time of the exam. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician 05:15pm blood wbc-10.0 rbc-3.26*# hgb-9.4*# hct-25.8*# mcv-79* mch-28.9 mchc-36.5* rdw-13.8 plt ct-160 06:12pm blood wbc-11.9* rbc-4.11*# hgb-11.6* hct-32.6*# mcv-79* mch-28.2 mchc-35.7* rdw-13.9 plt ct-173 11:14pm blood hct-32.4* 02:16am blood wbc-14.3* rbc-3.99* hgb-11.3* hct-31.8* mcv-80* mch-28.3 mchc-35.5* rdw-14.2 plt ct-173 04:21am blood wbc-12.1* rbc-3.50* hgb-10.2* hct-28.1* mcv-80* mch-29.1 mchc-36.3* rdw-14.2 plt ct-117* 06:29am blood wbc-8.7 rbc-3.26* hgb-9.1* hct-26.4* mcv-81* mch-27.9 mchc-34.4 rdw-14.1 plt ct-110* 05:00am blood wbc-8.0 rbc-3.35* hgb-9.3* hct-26.8* mcv-80* mch-27.9 mchc-34.9 rdw-14.2 plt ct-144* 05:00am blood neuts-78.7* lymphs-13.1* monos-5.8 eos-1.9 baso-0.4 05:15pm blood pt-14.3* ptt-46.7* inr(pt)-1.2* 06:12pm blood pt-14.3* ptt-38.8* inr(pt)-1.2* 06:12pm blood plt ct-173 04:21am blood plt ct-117* 06:29am blood plt ct-110* 05:00am blood plt ct-144* 06:12pm blood urean-12 creat-0.5 na-139 k-3.3 cl-109* hco3-24 angap-9 09:26pm blood na-138 k-3.3 cl-107 11:14pm blood na-137 k-3.0* cl-105 02:16am blood glucose-115* urean-9 creat-0.5 na-135 k-4.5 cl-106 hco3-25 angap-9 04:21am blood glucose-110* urean-13 creat-0.6 na-133 k-4.1 cl-100 hco3-28 angap-9 06:29am blood urean-14 creat-0.6 na-137 k-3.8 cl-105 05:00am blood urean-13 creat-0.7 na-138 k-3.8 cl-103 brief hospital course: the patient was admitted to the hospital and brought to the operating room on where the patient underwent aortic valve replacement (#23 st. tissue)-see operative note for details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod #4 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged in good condition with appropriate follow up instructions. medications on admission: naproxen 500mg twice daily prn arthritis pain fish oil 500mg daily multivitamins aspirin 81mg daily crestor 10mg daily hydrochlorothiazide 25mg daily cardizem cd 180mg daily sertraline 50mg daily clarithromycin dental prophylaxis discharge medications: 1. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). disp:*45 tablet(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 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:*2* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*65 tablet(s)* refills:*0* 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 6. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 7. multivitamin tablet sig: one (1) tablet po daily (daily). 8. rosuvastatin 5 mg tablet sig: two (2) tablet po daily (daily). 9. furosemide 20 mg tablet sig: two (2) tablet po once a day for 5 days. disp:*10 tablet(s)* refills:*0* 10. potassium chloride 20 meq tablet, er particles/crystals sig: two (2) tablet, er particles/crystals po once a day for 5 days. disp:*10 tablet, er particles/crystals(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: aortic valve replacement (#23 tissue) aortic stenosis - likely bicuspid,hypertension hyperlipidemia,depression,history of left ankle cellulitis arthritis past surgical history:bilateral knee replacements,d+c's cholecystectomy,tubal ligation discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage edema trace lower extremity edema 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 females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: recommended follow-up: you are scheduled for the following appointments wound check on 6 on at 11am surgeon: dr date/time: 1:45 cardiologist: dr. office will contact you with an appointment 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** md procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: unspecified essential hypertension other and unspecified hyperlipidemia congenital insufficiency of aortic valve knee joint replacement arthropathy, unspecified, site unspecified congenital stenosis of aortic valve 

Answer: The patient is high likely exposed to