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: hydrochlorothiazide / sulfonamides / doxycycline / codeine attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement(23mm st. porcine valve) and four vessel coronary artery bypass grafting(left internal mammary artery to left anterior descending, saphenous vein grafts to ramus, obtuse marginal, and posterior descending artery) history of present illness: mr. is a 73 year old male with mild symptoms of dyspnea on exertion over the last 6-12 months. a recent in revealed severe aortic stenosis with of 0.9cm2 and mean gradient of 49mmhg. his lvef was estimated at 50-55%. further evaluation included cardiac catheterization which revealed three vessel coronary artery disease. based upon the above, he was referred for cardiac surgical intervention. he denies a history of chest pain, syncope and congestive heart failure. past medical history: aortic stenosis coronary artery disease hypertension hypercholesterolemia type ii diabetes mellitus peripheral vascular disease splenic artery aneurysm, s/p coiling squamous cell carcinoma removal tonsillectomy social history: quit tobacco 30 years ago. admits to very light etoh consumption. currently married and lives with his wife. is retired. family history: denies premature coronary artery disease. physical exam: preop exam vitals: 130/70, 68, 12 general: wdwn male in no acute distress heent: oropharynx benign, eomi neck: supple, no jvd lungs: cta bilaterally heart: regular rate and rhythm, normal s1s2, 3/6 systolic ejection murmur which radiates to carotids abdomen: soft, nontender with normoactive bowel sounds ext: warm, no edema pulses: 2+ distally neuro: alert and oriented, cn 2- 12 grossly intact, no focal deficits noted pertinent results: intraop tee: pre-cpb: 1. the left atrium is mildly dilated. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is low normal (lvef 50-55%). transmitral doppler and tissue velocity imaging are consistent with grade i (mild) lv diastolic dysfunction. 3. right ventricular chamber size and free wall motion are normal. 4. there are simple atheroma in the aortic root. the ascending aorta is mildly dilated. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened and calcified. no masses or vegetations are seen on the aortic valve. there is moderate to severe aortic valve stenosis (area 0.8-1.0cm2). mild to moderate (+) aortic regurgitation is seen. the annulus measures 2.3 cm. 6. the mitral valve appears structurally normal with trivial mitral regurgitation. post-cpb: on infusion of phenylephrine, a-v pacing. well-seated bioprosthetic valve in the aortic position. trivial ai. no paravalvular leak. preserved biventricular systolic function. trace mr. aortic contour is normal post decannulation. brief hospital course: mr. was admitted and underwent aortic vavle replacement surgery along with coronary artery bypass grafting by dr. . for surgical details, please see seperate dictated operative note. following the operation, he was brought to the cvicu for invasive monitoring. within 24 hours, he awoke neurologically intact and was extubated without incident. he maintained stable hemodynamics and transferred to the sdu on postoperative day one. beta blockade was advanced as tolerated. over several days, he continued to make clinical improvements with diuresis. he remained in a normal sinus rhythm. his chest tubes, pacing wires and foley were removed without difficulty. he is voiding abd taking po on dc. pt sternum was slightly cellulitic. keflex was started. he will continue this for 5 days. pt recoomended home with vna. pt dc in stable conditoion. medications on admission: aspirin, amlodipine 10 qd, lisinopril 5 qd, metformin 500 , atenolol 100 qd, simvastatin 20 qd 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. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. disp:*60 tablet(s)* refills:*0* 3. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 5. metoprolol tartrate 50 mg tablet sig: 2.5 tablets po tid (3 times a day). disp:*225 tablet(s)* refills:*2* 6. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 10. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation: prn. disp:*60 suppository(s)* refills:*0* 11. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 5 days. disp:*20 capsule(s)* refills:*0* 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed: prn. disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: aortic stenosis, coronary artery disease - s/p avr/cabg hypertension hypercholesterolemia type ii diabetes mellitus peripheral vascular disease history of splenic artery aneurysm, s/p coiling discharge condition: good discharge instructions: 1)please shower daily. no baths. pat dry incisions, do not rub. 2)avoid creams and lotions to surgical incisions. 3)call cardiac surgeon if there is concern for wound infection. 4)no lifting more than 10 lbs for at least 10 weeks from surgical date. 5)no driving for at least one month. followup instructions: dr. in weeks, call for appt dr. in weeks, call for appt dr. in weeks, call for appt provider: , m.d. date/time: 1:40 provider: phone: date/time: 2:00 provider: , m.d. phone: date/time: 3:00 procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft transfusion of packed cells diagnoses: thrombocytopenia, unspecified anemia, unspecified coronary atherosclerosis of native coronary artery other postoperative infection cellulitis and abscess of trunk 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 peripheral vascular disease, unspecified other and unspecified hyperlipidemia personal history of other malignant neoplasm of skin 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 

Answer: The patient is high likely exposed to