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: patient recorded as having no known allergies to drugs attending: chief complaint: chief complaint: doe/fatigue major surgical or invasive procedure: aortic valve replacement, 25-mm mosaic tissue valve. coronary artery bypass grafting x1: saphenous vein graft to the marginal branch of the circumflex. history of present illness: history of present illness: 74-year-old gentleman who has had a history of angina and coronary artery disease since . he has had multiple cardiac catheterizations with prior ptca of the circumflex and rca and stenting of the lad. he had a positive exercise tolerance test in , which led to the cardiac cath. that cardiac catheterization and subsequent echocardiogram showed aortic stenosis, aortic insufficiency and 50% circumflex lesion. he was evaluated by dr. in early for surgical aortic valve replacement with possible revascularization and returns for surgery. past medical history: bone cancer for which he had a right bka in and currently wears bk prosthesis. childhood meningitis hpertension hpercholesterolemia non-insulin dependent diabetes mellitus gastritis in hypercalcemia benign prostatic hypertrophy coronary artery disease (lad stent , ptca rca/cx ) aortic stenosis aortic insufficiency past surgical history: right bka bilateral cataract surgeries tonsillectomy prior ptca and coronary stenting social history: occupation: retired priest/teacher last dental exam: lives with: wife : caucasian tobacco: never etoh: rare use family history: family history is significant in that one brother had ptca at age 50 and the other brother had cabg at age 50 and passed away at age72. other brother with mvr. physical exam: pulse: 60 resp: 14 o2 sat: 99% b/p right: 129/77 left: 122/70 height: 70" weight: 175lbs general: wdwn gentleman in nad skin: warm, dry and intact. chronic venous stasis changes of distal lle heent: ncat, perrla, eomi, sclera anicteric, op benign, teeth in good repair. neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr, nls1-s2, iii/vi sem abdomen: soft non-distended non-tender bowel sounds + mild hepatomegally extremities: warm , well-perfused no edema varicosities: none neuro: r bk prosthesis, grossly intact pulses: femoral right: 2+ left: 2+ dp right: absent left: 2+ pt : absent left: 1+ radial right: 2+ left: 2+ carotid bruit transmitted aortic murmur to (b) carotids. pertinent results: echocardiography report , (complete) done at 9:06:18 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 75 m hgt (in): 70 bp (mm hg): 140/60 wgt (lb): 170 hr (bpm): 50 bsa (m2): 1.95 m2 indication: cabg, avr and ? mvr icd-9 codes: 424.0, 424.1 test information date/time: at 09:06 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw02-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.2 cm <= 4.0 cm left atrium - four chamber length: 5.0 cm <= 5.2 cm left ventricle - septal wall thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.8 cm <= 5.6 cm left ventricle - ejection fraction: 55% >= 55% aorta - sinus level: 3.3 cm <= 3.6 cm aorta - ascending: *3.5 cm <= 3.4 cm aortic valve - peak velocity: *4.0 m/sec <= 2.0 m/sec aortic valve - peak gradient: *65 mm hg < 20 mm hg aortic valve - mean gradient: 36 mm hg aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 findings left atrium: normal la size. no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. right atrium/interatrial septum: normal ra size. left ventricle: moderate symmetric lvh. normal lv cavity size. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal diameter of aorta at the sinus, ascending and arch levels. focal calcifications in aortic root. simple atheroma in ascending aorta. simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic 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. the patient appears to be in sinus rhythm. patient. conclusions pre-bypass: the left atrium is normal in size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. there are simple atheroma in the ascending aorta. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is no pericardial effusion. dr. was notified in person of the results on at 8am before surgical incision.. post_bypass: preserved biventricular systolic function. lvef 55%. minimal tr and mild mr. there is a bioprosthesis in the native aortic position, stable and functioning well. there is mild central jet consistent with large bioprosthesis (25size). there is no perivalvular leak. the mean gradient is 7mm of hg across the prosthetic aortic valve. thoracic aorta is intact post surgery. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 11:26 brief hospital course: mr was a same day direct admission to the operating room for aortic valve replacement and coronary bypass grafting on . please see or report for details, in summary he had aortic valve replacement with #25 porcine valve and coronary bypass graft x1 with reverse saphenous vein graft to obtuse marginal artery. he received cefazolin for his perioperative antibiotics. he tolerated the operation well and was transfered from the operating room to the cardiac surgery intensive care unit in stable condition. he remained hemodynamically stable in the immediate post-op period and over the next several hours he awoke neurologically intact, was weaned from the ventilator and was extubated. on the morning of pod1 the patient was noted to have a right apical pneumothorax that expanded over the next several hours and a chest tube was placed to resolve the pneumothorax. he was transferred to the stepdown floor later on pod1. he was begun on bblockers and diuretics and these were titrated to response. all tubes lines and drains were removed according to cardiac surgery protocols. once on the floor his activity was advanced with the assistance of the nurses and physical therapy. he was aggressively diuresed. he was disoriented on post-operative day three so his narcotics were discontinued. he improved overtime. the remainder of his post operative course was uneventful. he was discharged home on . he will follow-up as an outpatient. medications on admission: lipitor 80', metformin 500', gemfibrozil 600", omeprazole 20", atenolol 50', asa 81', saw -, mvi', coenzyme q-10", glucosamine/chondrotin-qd, fish oil 1000', fexofenadine-prn, viagra-prn, epi-pen 0.3 im/prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 3. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 5. 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* 6. ibuprofen 600 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for pain: take with food and water. disp:*90 tablet(s)* refills:*0* 7. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*5 tablet(s)* refills:*2* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. metformin 500 mg tablet sig: one (1) tablet po daily (daily). 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. disp:*5 tab sust.rel. particle/crystal(s)* refills:*2* 11. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 12. glucosamine chondroitin maxstr 500-400 mg capsule sig: one (1) capsule po once a day. 13. fish oil 1,000 mg capsule sig: one (1) capsule po once a day. 14. saw 80 mg capsule sig: one (1) capsule po twice a day. 15. coenzyme q10 10 mg capsule sig: one (1) capsule po once a day. discharge disposition: home with service facility: vna discharge diagnosis: s/p avr(25medtronic porcine)cabgx1(svg-om) pmh: bone ca s/p r bka, htn, ^chol, dm2, gastritis, hypercalcemia, bph, cad(pci-rca/cx),as, bilat cataracts, tonsillectomy discharge condition: good discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming monitor wounds for infection and report any redness, warmth, swelling, tenderness or drainage please take temperature each evening and report any fever 100.5 or greater 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: please call to schedule appointments surgeon dr in weeks at heart ccenter () primary care dr in weeks cardiologist dr 1-2 weeks heart center () procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart (aorto)coronary bypass of one coronary artery cardioplegia arterial catheterization open and other replacement of aortic valve with tissue graft diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled coronary atherosclerosis of unspecified type of vessel, native or graft aortic valve disorders other and unspecified hyperlipidemia iatrogenic pneumothorax personal history of malignant neoplasm of bone 

Answer: The patient is high likely exposed to