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: amiodarone analogues attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: redo sternotomy, aortic valve replacement (25mm st. porcine) history of present illness: this 78 year old patient with complex past medical history s/p coronary artery bypass graft x 4 in . pt had a cardiac cath at nebh in . the aortic area was 1.0 with a mean gradient of 33 and an ef of 58%. then he developed chest pain and ruled in for mi with a troponin of 6.5.he had a cardiac cath at at that time which showed a valve area of 0.8 with a mean gradient of 34 and an ef of 40%. the study showed significant native cad but all grafts were patent.he declined intervention at that time because he was going to for the winter. when he returned this spring he was complaining of increased dyspnea on exertion. he had a cardiac cath at nebh which showed severe aortic stenosis and a calculated of 0.6 cm2 and a mean gradient of 34-35 mmhg. this catheterization also showed severe 3 vessel native cad. the lima graft to the lad was patent. the vein graft to the pda was patent with a significant lesion in the native vessel downstream from the graft. the vein graft to diagonal branch is patent with distal native vessel severe disease and patent saphenous vein graft to the obtuse marginal with diffuse attenuation of native vessels. on he then underwent stenting of the pda via the svg. he now presents for surgical evaluation for aortic valve replacement. past medical history: aortic stenosis s/p redo sternotomy, aortic valve replacement this admission pmh: coronary artery disease, s/p cabg chronic atrial fibrillation non-insulin dependent diabetes mellitus hypertension hyperlipidemia social history: the patient is a retired salesman and lives with his wife. has a distant smoking history. he drinks an occassional glass of wine, no history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: physical exam pulse: 78 resp: 18 b/p left: 110/70 height: 5'" weight: 195lbs general: wd/wn male, nad skin: dry intact heent: perrla eomi , except left eye neck: supple full rom , -jvd chest: lungs clear bilaterally , healed midline scar from cabg heart: rrr irregular murmur 2/6 sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none healed rle from groin to anke neuro: grossly intact, a&o x 3 pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit: right: none left: none pertinent results: 01:45am blood wbc-8.9 rbc-2.83* hgb-9.6* hct-27.2* mcv-96 mch-34.0* mchc-35.4* rdw-13.3 plt ct-129* 01:45am blood pt-16.2* inr(pt)-1.4* 01:45am blood glucose-132* urean-26* creat-0.7 na-136 k-4.2 cl-104 hco3-23 angap-13 01:45am blood mg-2.2 pre-cpb:1. the left atrium is moderately dilated. the left atrial appendage emptying velocity is depressed (<0.2m/s). a left atrial appendage thrombus cannot be excluded. 2. a patent foramen ovale is present. 3. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild to moderate regional left ventricular systolic dysfunction with inferior hypokinesis. there is mild global left ventricular hypokinesis (lvef = 40 %). overall left ventricular systolic function is moderately depressed (lvef= 40 %). 4. the right ventricular free wall is hypertrophied. the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. 5. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 6. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). mild (1+) aortic regurgitation is seen. 7. the mitral valve leaflets are mildly thickened. there is a minimally increased gradient consistent with trivial mitral stenosis. mild to moderate (+) mitral regurgitation is seen. 8. there is a moderate right pleural effusion. 9. there is a trivial/physiologic pericardial effusion. drs. and were notified in person of the results. post-cpb: on infusions of epinephrine and phenylephrine. av pacing. well-seated bioprosthetic valve in the aortic position. trivial ai. no paravalvular leak. mitral regurgitation is 1+. tr is 1+. there is preserved biventricular systolic function on inotropic support. the aortic contour is normal post decannulation. the size of the left pleural effusion is significantly reduced. 05:00am blood wbc-11.0 rbc-3.07* hgb-10.2* hct-29.6* mcv-96 mch-33.1* mchc-34.4 rdw-13.5 plt ct-594* 05:00am blood pt-25.4* inr(pt)-2.4* 05:00am blood glucose-52* urean-22* creat-0.8 na-136 k-4.7 cl-100 hco3-23 angap-18 brief hospital course: mr was admitted preoperatively for heparinization while off coumadin. on he was brought to the operating room for redo sternotomy and aortic valve replacement with #25 porcine valve. cross clamp time=75 minutes.cardiopulmonary bypass time=107 minutes. please see dr operative report for further details. he tolerated the operation well and was transferred to the cardiac surgery icu in stable condition on epinephrine and neosynephrine for optimal hemodynamic support. he was weaned from the ventilator and extubated on pod#1. upon extubation he was found to be restless and somewhat agitated. this was initially felt to be from the narcotics he had received however these symptoms persisted. the neurology team was consulted and a head ct was done(a preliminary report read "no hemorrhage or large territorial infarct. ill-defined low attenuation foci in the right frontal centrum semiovale/corona radiata white matter (2:25-28), may represent infarcts, age indeterminate). he was seen by dr who felt the patient did not have a new infarct. over the next 48 hours his neurological exam improved dramatically, all lines and drains were discontinued in a timely fashion. beta-blocker and diuresis was initiated. on pod3 he was transferrred to the stepdown floor for continued post-op care and recovery. once on the floor he was noted to have a small amount of serous drainage from the inferior aspect of his sternal wound and was prophylactically started on keflex. the remainder of his hospital course was essentially uneventful. over the next several days he made slow but continuous progress in his physical activity and on pod #12 he was cleared for discharge by the cardiac surgery covering attendings, to home with vna. all follow up appointments were advised. medications on admission: digoxin 250 mcg 1 tablet daily simvastatin 20 mg 1 tablet daily warfarin 2.5 mg 1 tablet daily, 2 tablets on sunday lisinopril 10 mg daily metoprolol 25 mg twice a day plavix 75 mg daily glyburide 5 mg twice a day aspirin 325 mg daily nitro patch prn discharge medications: 1. potassium chloride 10 meq tablet sustained release sig: two (2) tablet sustained release po once a day for 1 weeks. disp:*14 tablet sustained release(s)* refills:*0* 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). 4. glyburide 5 mg tablet sig: two (2) tablet po q am. disp:*60 tablet(s)* refills:*2* 5. warfarin 1 mg tablet sig: adjust dose to target inr 2-2.5 tablets po daily (daily): pt to receive 2.5 mg on . home regime preop was 2.5mg qd with 5mg on sunday. 6. acetaminophen 325 mg tablet sig: two (2) tablet po every six (6) hours as needed for pain/fever. 7. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 8. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 9. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 10. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 11. lisinopril 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 12. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 13. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po three times a day. disp:*45 tablet(s)* refills:*2* 14. keflex 500 mg capsule sig: one (1) capsule po twice a day for 10 days. 15. glyburide 5 mg tablet sig: one (1) tablet po q pm. disp:*60 tablet(s)* refills:*2* 16. furosemide 20 mg tablet sig: one (1) tablet po once a day for 1 weeks. disp:*7 tablet(s)* refills:*0* discharge disposition: home with service facility: tbd discharge diagnosis: aortic stenosis s/p redo sternotomy, aortic valve replacement(25 porcine) pmh: coronary artery disease, s/p cabg chronic atrial fibrillation non-insulin dependent diabetes mellitus hypertension hyperlipidemia 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, and while taking narcotics no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **keep a log of your blood sugars and present to your pcp 1 week visit** followup instructions: dr. in 4 weeks () dr. , in 1 week, please resume coumadin/inr follow up with dr. neurology -dr. -see in weeks please call for appointments have inr drawn by vna with results to dr. procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation aortocoronary bypass status aortic valve disorders percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia ostium secundum type atrial septal defect old myocardial infarction long-term (current) use of anticoagulants hypoxemia surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation seroma complicating a procedure 

Answer: The patient is high likely exposed to