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: shellfish attending: chief complaint: exercise intolerance and fatigue major surgical or invasive procedure: 1. coronary bypass grafting x3 with the left internal mammary artery to left anterior descending artery and reversed saphenous vein graft to the right coronary artery and the obtuse marginal artery. 2. aortic valve replacement with an perimount magna ease 23-mm pericardial valve, model #3300 tfx. history of present illness: 68 year old male of with severe aortic stenosis and a decline in his activity tolerance referred for cardiac catheterization. cath revealed severe coronary artery disease and he was admitted for planned surgery on . past medical history: hypertension hyperlipidemia diabetes type 2 severe aortic stenosis remote bowel obstruction possible tia approximately 25 years ago past surgical history: vasectomy social history: race:caucasian last dental exam:1 month ago lives with:wife occupation:retired, part-time at a print and design company tobacco:quit 40 years ago etoh: 2 drinks per day family history: mitral valve replacement and cva, mother had a cva in her 60's physical exam: vs (pre): 182/102, 182/89, 94, 14, 97% ra fs 203 (post): 159/83, 87, 20, 95% ra gen: a+ox3, pleasant and cooperative, nad neck: 2+ carotids, no bruits appreciated cv: rrr, nl s1s2 3/6 systolic murmur noted resp: ls clear throughout abd: soft, nontender, + bs ext: right radial approach-cath, hemoband in place, no bleeding/ hematoma/ ecchymosis noted, 2+ radial and ulnar pulses, + csm right hand. dp/pt per doppler, no pedal edema ekg: sr, hr 93 labs: : wbc 7.2, hct 41.6, plt 241, inr 1.1, na 142, k 4.4, bun 24, cr 1.2 pertinent results: cath: 1. coronary angiography in this right dominant system demonstrated three vessel disease. the lmca had no angiographically apparent disease. there was a calcified 70% stenosis in the proximal lad. the lad was not a large vessel in distribution. the diagonal branches were small. there was a large om1/ramus that was free of disease. there was a tubular 80% stenosis in the mid-lcx leading to a large om2. the rca was a large vessel in its distribution. there was no disease in the distal rca or its pda or pl branches. 2. resting hemodynamics revealed normal blood pressures with an aortic pressure of 121/75 mmhg. carotid u/s: right ica stenosis <40%. left ica stenosis <40%. echo: prebypass: no mass/thrombus is seen in the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 65-70%). right ventricular chamber size and free wall motion are normal. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. postbypass (#1) there is a new bioprosthetic valve in the aortic position. there is good leaflet excursion but there is at least moderate aortic regurgitation which appears to be paravalvular. postbypass (#2) the same bioprosthetic aortic valve continues to have some regurgitation but it now appears to be mild. however, it still appears perivalvular. after protamine and ffp, the leak is now trace. the peak/mean gradients are 14/7 mmhg at a co of 5.0 l/min. left ventricular function continues to be normal. trace mitral and tricuspid regurgitation persist. the thoracic aorta is intact. pre-op labs: 09:30am pt-14.6* ptt-91.5* inr(pt)-1.3* 09:30am plt count-197 09:30am wbc-5.7 rbc-3.79* hgb-13.0* hct-36.2* mcv-96 mch-34.3* mchc-35.9* rdw-13.5 09:30am %hba1c-6.8* eag-148* 09:30am albumin-3.9 09:30am alt(sgpt)-34 ast(sgot)-26 alk phos-31* amylase-39 tot bili-0.2 09:30am glucose-160* urea n-26* creat-1.0 sodium-136 potassium-4.4 chloride-100 total co2-25 anion gap-15 11:30am urine rbc-0-2 wbc-0-2 bacteria-none yeast-none epi-0-2 11:30am urine blood-tr nitrite-neg protein-neg glucose-100 ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-neg discharge labs: 04:55am blood wbc-10.3 rbc-3.31* hgb-10.6* hct-31.6* mcv-96 mch-32.1* mchc-33.6 rdw-14.5 plt ct-315 04:55am blood pt-17.4* inr(pt)-1.6* 04:55am blood urean-35* creat-1.5* na-137 k-3.6 cl-96 04:55am blood glucose-150* urean-36* creat-1.5* na-134 k-4.1 cl-94* hco3-29 angap-15 radiology report chest (pa & lat) study date of 9:41 am medical condition: 68 year old man with s/p cardiac surgery final report: pa and lateral chest compared to through 24: small right pleural effusion has increased, small left pleural effusion stable since . no appreciable atelectasis. mild-to-moderate postoperative enlargement of the cardiac silhouette is stable. no pneumothorax or pulmonary edema. left pic line ends in the mid svc. brief hospital course: mr. was admitted following his cardiac cath and underwent usual pre-operative testing. on he was brought to the operating room for coronary artery bypass grafting and aortic valve replacement. please see operative report for surgical details. in summary he had: 1. coronary bypass grafting x3 with the left internal mammary artery to left anterior descending artery and reversed saphenous vein graft to the right coronary artery and the obtuse marginal artery. 2. aortic valve replacement with an perimount magna ease 23-mm pericardial valve, model #3300 tfx. his bypass time was 135 minutes with a crossclamp of 117 minutes. he tolerated the operation well and following surgery he was transferred to the cvicu for invasive monitoring in stable condition. within 24 hours he was weaned from sedation, awoke neurologically intact and extubated. on post-op day one beta blockers and diuretics were started and he was diuresed towards his pre-op weight. on post-op day 3 he was transferred to step-down floor for further care and post-operative recovery. chest tubes were removed per protocol. ventricular pericardial pacing wires were removed but atrial epicardial wires were cut at the skin, as resistance was met on attempted removal. he did develop post-op a-fib and was started on amiodarone and coumadin. he converted to sinus rhythm and the coumadin was stopped. he also developed erythema at the evh site on his left knee and was started on keflex. on the stepdown floor he worked with physical therapy and nursing to increase activity and endurance. on pod 8 he was ready for discharge home with visiting nurses. he is to followup with dr in 3 weeks medications on admission: atenolol - (prescribed by other provider) - 50 mg tablet - 1 tablet(s) by mouth every morning glimepiride - (prescribed by other provider) - 4 mg tablet - 2 tablet(s) by mouth every morning hydrochlorothiazide - (prescribed by other provider) - 25 mg tablet - 1 tablet(s) by mouth every morning metformin - (prescribed by other provider) - 500 mg tablet sustained release 24 hr - 2 tablet(s) by mouth twice a day simvastatin - (prescribed by other provider) - 20 mg tablet - 1 tablet(s) by mouth every evening valsartan - (prescribed by other provider) - 160 mg tablet - 1 tablet(s) by mouth every morning medications - otc aspirin - (prescribed by other provider) - 81 mg tablet, chewable - 1 tablet(s) by mouth every morning calcium carbonate - (prescribed by other provider) - 500 mg (1,250 mg) tablet - 1 tablet(s) by mouth daily glucosamine-chondroit-vit c-mn - (prescribed by other provider) - 500 mg-400 mg capsule - 1 capsule(s) by mouth twice a day multivitamin - (prescribed by other provider) - tablet - 1 tablet(s) by mouth once a day discharge medications: 1. 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* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 4. simvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: 1.5 tablets po tid (3 times a day). disp:*135 tablet(s)* refills:*2* 7. amiodarone 200 mg tablet sig: as directed tablet po bid (2 times a day): 400mg x7 days then 400mg qd x7 days then 200mg qd. disp:*65 tablet(s)* refills:*1* 8. cephalexin 500 mg capsule sig: one (1) capsule po q8h (every 8 hours) for 10 days. disp:*30 capsule(s)* refills:*0* 9. glimepiride 4 mg tablet sig: two (2) tablet po once a day. 10. lasix 40 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 11. potassium chloride 10 meq tablet sustained release sig: one (1) tablet sustained release po once a day for 2 weeks. disp:*14 tablet sustained release(s)* refills:*0* 12. metformin 1,000 mg tablet sig: one (1) tablet po twice a day: do not resume until after bun/cr and k+ checked on . if cr normalized will resume at that time. otherwise hold until directed to resume. discharge disposition: home with service facility: area vna discharge diagnosis: coronary artery disease and aortic stenosis s/p coronary bypass grafting x3 and aortic valve replacement past medical history: hypertension hyperlipidemia diabetes type 2 severe aortic stenosis remote bowel obstruction possible tia approximately 25 years ago s/p vasectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema- 1+ pedal bilat 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: you are scheduled for the following appointments surgeon: dr. on at 1:30pm cardiologist: dr. on at 1:40pm 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: please check bun/cr/k+ on call results to cardiac surgery office @ procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries left heart cardiac catheterization open and other replacement of aortic valve with tissue graft diagnoses: other iatrogenic hypotension thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery other postoperative infection unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders personal history of tobacco use other and unspecified hyperlipidemia cellulitis and abscess of leg, except foot surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits obesity, unspecified accidents occurring in residential institution 

Answer: The patient is high likely exposed to