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 / lyrica / nabumetone attending: chief complaint: mitral regurgitation major surgical or invasive procedure: mitral valve replacement (27 st. porcine) history of present illness: mr. is a 89 year old gentleman who recently has been experiencing worsening shortness of breath and dyspnea on exertion. work-up for this complaint revealed severe mitral regurgitation. he presented to for mitral valve replacement. past medical history: mitral regurgitation benign prostatic hypertrophy mild copd glaucoma transitional cell bladder tumor/hematuria first degree atrioventricular block osteoarthritis dejenerative joint disease pulmonary hypertension neuropathy carpal tunnel syndrome s/p appendectomy s/p tonsillectomy s/p cataract surgery s/p total knee replacement (bilateral) s/p back surgery social history: mr. is retired. he quit smoking 40 years ago, but has a 30 pack year history. he drinks socially only. he lives alone. family history: he denies a family history of premature coronary artery disease. physical exam: general: well appearing elderly gentleman in nad vs: 98.6, 74, 135/67, 20, 945 on ra heent: unremarkable chest: left chest pacer site w/ intact steri-strips and small area of eccyhmosis. sternal incision healing well w/ no redness or drainage. cor: rrr s1, s2 abd; soft, round, nt, non-distended, +bs extrem: trace ble edema. lue decreasing. neuro: intact. pertinent results: hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 12:55pm 27.1* differential neuts bands lymphs monos eos baso atyps metas 12:06pm 81.4* 16.5* 1.5* 0.6 0 added cad at 12:34 pm on basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 05:30am 189 basic coagulation (fibrinogen, dd, tt, reptilase, bt) fibrino 02:42am 697*# source: line-arterial chemistry renal & glucose glucose urean creat na k cl hco3 angap 12:55pm 151* 48* 1.4* 140 4.1 103 27 14 estimated gfr (mdrd calculation) estgfr 01:25pm using this1 source: line-a / sample slightly hemolyzed , m 89 radiology report chest (pa & lat) study date of 10:40 am , r. csurg csru sched chest (pa & lat) clip # reason: s/p ppm placement. check leads and ptx. medical condition: 89 year old man with new dual chamber ppm. reason for this examination: s/p ppm placement. check leads and ptx. final report history: pacemaker placement, to evaluate for leads and pneumothorax. findings: in comparison with study , there has been placement of a dual-lead pacemaker device, with the leads in the region of the right atrium and apex of the right ventricle. specifically, no evidence of pneumothorax. the right ij sheath has been removed. left retrocardiac opacity and small effusion persists. , (complete) done at 9:50:00 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 89 m hgt (in): 70 bp (mm hg): 134/86 wgt (lb): 207 hr (bpm): 58 bsa (m2): 2.12 m2 indication: intra-op tee for mvr, ? tvr icd-9 codes: 745.5, 786.05, 440.0, 424.0 test information date/time: at 09:50 interpret md: , 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 ventricle - septal wall thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.3 cm <= 5.6 cm left ventricle - systolic dimension: 3.3 cm left ventricle - fractional shortening: 0.38 >= 0.29 left ventricle - ejection fraction: 55% to 60% >= 55% findings left atrium: moderate la enlargement. right atrium/interatrial septum: dynamic interatrial septum. pfo is present. left-to-right shunt across the interatrial septum at rest. left ventricle: normal lv wall thickness, cavity size, and global systolic function (lvef>55%). right ventricle: normal rv chamber size and free wall motion. aorta: simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. no as. no ar. mitral valve: mildly thickened mitral valve leaflets. partial mitral leaflet flail. mild mitral annular calcification. no ms. eccentric mr jet. effective regurgitant orifice is >=0.40cm2. mr vena contracta is >=0.7cm severe (4+) mr. to the eccentric mr jet, its severity may be underestimated (coanda effect). tricuspid valve: no ts. mild tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. 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. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. see conclusions for post-bypass data the post-bypass study was performed while the patient was receiving vasoactive infusions (see conclusions for listing of medications). conclusions pre-bypass: 1. the left atrium is moderately dilated. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. 2. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). 3. right ventricular chamber size and free wall motion are normal. 4. there are simple atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. there is no aortic valve stenosis. no aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. there is partial mitral leaflet flail. an eccentric, anterior directed jet of severe mr is seen. the effective regurgitant orifice is >=0.40cm2 the mitral regurgitation vena contracta is >=0.7cm. severe (4+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). dr. was notified in person of the results. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine and is being av paced 1. a bioprosthesis is well seated in the mitral position. trace central mr is noted that is normal for this prosthesis. mean gradient across this valve is 7 mmof hg. 2. lv function is unchanged. rv function initially moderate depressed then improved to normal. 3. no flow is seen across the interatrial septum, evidence of septal repair/closure seen. 4. aorta is intact post decannulation. 5. tr is still mild. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, md, interpreting physician 12:51 brief hospital course: on , mr. a mitral valve replacement with a 17mm st. porcine valve. this procedure was performed by dr. . please refer to the operative report for further details. he tolerated the procedure well and was transferred in critical but stable condition to the surgical intensive care unit. he was weaned from his pressors and extubated on post operative day one. his chest tubes were removed. he was found to be in complete heart block under his temporary pacemaker on post operative day 2 and therefore cardiology was consulted for consideration of a permanent pacemaker placement. on post operative day five his permanent pacemaker was placed. he was transferred from the icu on pod# 6. his pacer was interogated by ep and set for ddd. the remainder of his postoperative course was essentially uneventful. he continued diuresis and betablockade. he was seen in consultation by the physical therapy service and he was thought to be appropriate for interim rehab stay. he continued to progress and by post-operative day #8 he was ready for discharge to rehab for further conditioning, increase in stregnth and endurance. all appropriate appointments were advised. medications on admission: omepraqzole 20 mg/d avodart 0.5mg/d timolol ophth. gtt xalantan ophth. gtt lasix 20mg/d propoxyphene 500mg tid discharge medications: 1. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic qam (once a day (in the morning)). 4. 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* 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 7. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 10. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 12. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 13. diphenhydramine hcl 12.5 mg/5 ml elixir sig: po q6h (every 6 hours) as needed for itching. discharge disposition: extended care facility: house nursing home - discharge diagnosis: mitral regurgitation s/p mitral valve replacement benign prostatic hypertrophy chronic obstructive pulmonary disease degenerative joint disease pulmonary hypertension s/p bilateral knee replacements glaucoma carpal tunnel syndrome first degree atrioventricular block s/p pacer discharge condition: good discharge instructions: shower daily, no baths or swimming no lotions, creams or powders to incisions report any redness of, or drainage from incisions report any fever greater than 100.5 report any weight gain greater than 2 pounda day or 10 pounds a week no driving for 4 weeks and off all narcotics no lifting more than 10 pounds for 10 weeks take all medications as directed followup instructions: dr. in 2 weeks dr. in 2 weeks dr. in weeks () please call for appointments procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle open and other replacement of mitral valve with tissue graft diagnoses: other iatrogenic hypotension mitral valve disorders congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified cardiac complications, not elsewhere classified other chronic pulmonary heart diseases unspecified glaucoma hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) atrioventricular block, complete personal history of malignant neoplasm of bladder surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation hypovolemia contact dermatitis and other eczema, unspecified cause rupture of chordae tendineae 

Answer: The patient is high likely exposed to