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: azithromycin attending: chief complaint: fatigue major surgical or invasive procedure: avr ( mechanical valve), replacement ascending aorta (30 mm gelweave graft) history of present illness: 66 year old male with known aortic stenosis and aortic insufficiency, recently underwent cardiac catherzation that revealed coronary artery disease. he has known bicuspid aortic valve and noted for dilated aorta. he was referred for surgical evaluation. past medical history: coronary artery disease type a aortic aneurysm aortic stenosis aortic insufficiency hypertension first degree av block atrial fibrillation hyperlipidemia s/p ablation for svt s/p tonsillectomy social history: occupation: retired electronics technician lives with: wife : never etoh: drinks per week family history: father died of arteriosclerosis at 78 ( unspecified) physical exam: pulse: 72 reg resp: o2 sat: b/p right: 143/77 left: 136/79 height: 68" weight: 175# general: skin: dry intact heent: perrla eomi anicteric sclera, op unremarkable neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr irregular murmur 3/6 sem radiates to carotids and throughout precordium; faint diastolic murmur heard best at rusb abdomen: soft non-distended non-tender bowel sounds + no hsm or cva tenderness extremities: warm , well-perfused edema none varicosities: none neuro: grossly intact, mae strengths, nonfocal exam pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit :murmur is transmitted to both carotids pertinent results: echocardiography report , portable tte (complete) done at 11:55:58 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 66 m hgt (in): bp (mm hg): 86/58 wgt (lb): hr (bpm): 84 bsa (m2): indication: aortic valve disease. bicuspid aortic valve. severe aortic stenosis. aortic regurgitation. icd-9 codes: 786.05, 786.51, 799.02, 440.0, 746.4, 424.0 test information date/time: at 11:55 interpret md: , md test type: portable tte (complete) son: , md doppler: full doppler and color doppler test location: west or cardiac contrast: none tech quality: adequate tape #: 2009w1-: machine: echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.6 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.7 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.5 cm <= 5.6 cm left ventricle - ejection fraction: 55% to 60% >= 55% left ventricle - stroke volume: 63 ml/beat left ventricle - cardiac output: 5.28 l/min aorta - sinus level: *4.5 cm <= 3.6 cm aorta - sinotubular ridge: *4.5 cm <= 3.0 cm aorta - ascending: *4.9 cm <= 3.4 cm aortic valve - peak velocity: *3.4 m/sec <= 2.0 m/sec aortic valve - peak gradient: *45 mm hg < 20 mm hg aortic valve - mean gradient: 25 mm hg aortic valve - lvot vti: 20 aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *1.0 cm2 >= 3.0 cm2 findings right atrium/interatrial septum: normal interatrial septum. left ventricle: moderate symmetric lvh. normal lv cavity size. normal regional lv systolic function. overall normal lvef (>55%). no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: moderately dilated aortic sinus. moderately dilated ascending aorta. simple atheroma in descending aorta. aortic valve: bicuspid aortic valve. severe as (area 0.8-1.0cm2). mild (1+) ar. mitral valve: normal mitral valve leaflets. no mvp. mild to moderate (+) mr. tricuspid valve: mild tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. 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. conclusions pre-bypass there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. 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. the aortic root is moderately dilated at the sinus level. the ascending aorta is moderately dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve is bicuspid. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). mild eccentric (1+) aortic regurgitation is seen. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. post-cpb: a prosthetic aortic valve is in place with no leak and no ai. residual mean gradient is 12. mr remains +. aorta intact. good biventricular systolic fxn. other parameters as pre-cpb. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 11:33 basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 07:30am 367 07:30am 24.7* 2.4* brief hospital course: admitted same day surgery and underwent aortic valve replacement and ascending aorta replacement. see operative report for further details. he received cefazolin for perioperative antibiotics. he was transferred to the intensive care unit for hemodynamic monitoring. required vasoactive medications for blood pressure management. in first twenty four hours he weaned from sedation, awoke neurologically intact and was extubated without complications. on post operative day one he was started on betablockers, antihypertensives for blood pressure control and diuretics. in addition he was started on coumadin for mechanical valve. he was transfered to the floor. physical therapy worked with him on strength and mobility. post operative day two his epicardial wires and chest tubes were removed. on pod#4 he was cleared for discharge to home with vna services. inr was 2.4- given 5mg coumadin sat and sunday and inr to be checked monday and called to mwmc coumadin clinic. medications on admission: nifedipine 90 mg daily gemfibrozil 600 mg diovan 320 mg daily hctz 25 mg daily digoxin 0.125 mg daily asa 81 mg daily doxazosin 2 mg daily lorazepam 0.5 mg prn sleep discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 3. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*80 tablet(s)* refills:*0* 4. furosemide 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 5. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 7 days. disp:*7 tab sust.rel. particle/crystal(s)* refills:*0* 6. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 7. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 8. coumadin 2 mg tablet sig: as directed tablet po once a day: dose 5mg on then dose to be determined by clinic. goal inr 3.0. disp:*60 tablet(s)* refills:*2* 9. aspirin 81 mg tablet sig: one (1) tablet po once a day. 10. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: vna discharge diagnosis: type a aortic aneurysm s/p ascending aorta replacement aortic stenosis s/p avr aortic insufficiency s/p avr coronary artery disease hypertension first degree av block atrial fibrillation hyperlipidemia s/p ablation for svt s/p tonsillectomy discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr in weeks - at heart center - please call for appointment dr in 1 week - please call for appointment dr in weeks - please call for appointment pt/inr for coumadin dosing, indication mechanical aortic valve - goal inr 2.5-3.0 first draw monday results to clinic heart center phone fax procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension thoracic aneurysm without mention of rupture atrial fibrillation aortic valve disorders other and unspecified hyperlipidemia long-term (current) use of anticoagulants congenital insufficiency of aortic valve first degree atrioventricular block 

Answer: The patient is high likely exposed to