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: shortness of breath major surgical or invasive procedure: aortic valve replacement ( tissue) history of present illness: is a year old woman with known aortic stenosis and coronary artery disease. she has had multiple recent admissions for pulmonary edema. she was admitted for cardiac surgery. past medical history: aortic stenosis s/p valvulopasty in coronary artery disease mrsa (left elbow cellulitis) hypertension pancreatitis gastric esophageal reflux disease hypercholesterolemia colovesical fistula repair s/p trach after valvuloplasty and pancreatitis in ' bilateral cataracts social history: she lives with her family and is widowed. she denies tobacco and alcohol use. family history: non-contributory physical exam: at the time of admission, ms. was in no acute distress. she is noted to use a cane for ambulation. her skin is intact. her neck is supple with no jvd. her lungs are clear to ausculation bilaterally. her heart is of regular rate and rhythm with a iii/vi systolic ejection fraction. her abdomen is soft, non-tender, and non-distended. her extremities are warm and well-perfused with trace edema. left lower extremity varicosities are noted. pertinent results: 05:00am blood wbc-9.2 rbc-2.99* hgb-9.3* hct-27.3* mcv-91 mch-31.0 mchc-33.9 rdw-15.0 plt ct-127* 05:00am blood plt ct-127* 05:00am blood glucose-97 urean-21* creat-0.9 na-138 k-4.5 cl-104 hco3-28 angap-11 05:15am blood wbc-7.5 rbc-2.80* hgb-9.2* hct-26.1* mcv-93 mch-32.7* mchc-35.1* rdw-14.3 plt ct-230# 05:15am blood glucose-97 urean-20 creat-0.9 na-141 k-4.5 cl-102 hco3-32 angap-12 echocardiography report , (complete) done at 10:19:25 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): f hgt (in): 65 bp (mm hg): 134/78 wgt (lb): 155 hr (bpm): 67 bsa (m2): 1.78 m2 indication: intraoperative tee for avr. aortic valve disease. chest pain. coronary artery disease. hypertension. left ventricular function. mitral valve disease. preoperative assessment. right ventricular function. shortness of breath. icd-9 codes: 745.5, 786.05, 786.51, 440.0, 424.1, 424.0 test information date/time: at 10:19 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 #: 2009aw5-: machine: aw5 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 3.6 cm <= 5.6 cm left ventricle - systolic dimension: 1.9 cm left ventricle - fractional shortening: 0.47 >= 0.29 left ventricle - ejection fraction: 60% >= 55% aorta - ascending: 3.4 cm <= 3.4 cm aortic valve - peak velocity: *3.9 m/sec <= 2.0 m/sec aortic valve - peak gradient: *59 mm hg < 20 mm hg aortic valve - mean gradient: 34 mm hg aortic valve - valve area: *0.4 cm2 >= 3.0 cm2 mitral valve - mva (p t): 1.6 cm2 mitral valve - e wave: 1.3 m/sec mitral valve - a wave: 1.7 m/sec mitral valve - e/a ratio: 0.76 findings left atrium: no spontaneous echo contrast in the body of the laa. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left-to-right shunt across the interatrial septum at rest. small secundum asd. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. mild symmetric lvh. normal lv cavity size. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: simple atheroma in aortic root. normal ascending aorta diameter. simple atheroma in ascending aorta. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. severe as (aova <0.8cm2). moderate to severe (3+) ar. mitral valve: severely thickened/deformed mitral valve leaflets. severe mitral annular calcification. mild valvular ms (mva 1.5-2.0cm2). moderate (2+) mr. tricuspid valve: mild tr. 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. conclusions prebypass 1. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. a left-to-right shunt across the interatrial septum is seen at rest. a small secundum atrial septal defect is present. 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 normal (lvef>55%). 3.right ventricular chamber size and free wall motion are normal. 4.there are simple atheroma in the aortic root. 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 severe aortic valve stenosis (area <0.8cm2). moderate to severe (3+) aortic regurgitation is seen. 5.the mitral valve leaflets are severely thickened/deformed. there is severe mitral annular calcification. there is mild valvular mitral stenosis (area 1.5-2.0cm2). moderate (2+) mitral regurgitation is seen. 6. dr. was notified in person of the results on at 845am. post bypass 1. patient is a paced and receiving an infusion of phenylephrine. 2. biventricular systolic function is unchanged. 3. bioprosthetic valve seen in the aortic position. the leaflets move well and the valve appears well seated. no aortic insufficiency seen. peak gradient across the aortic valve is 27 mm hg and the mean gradient is 11 mm hg. 4. mild mitral regurgitation is present. 5. aorta intact post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 00:13 ?????? caregroup is. all rights reserved. brief hospital course: on ms. was taken to the operating room and underwent an aortic valve replacement with a st. tissue aortic valve. this procedure was performed by dr. . please see the operative note for details of the case. she tolerated the procedure well and was transferred in critical but stable condition to the surgical intensive care unit. she was extubated on the following day and her pressors were weaned. she was drowsy but easy to arrouse. on post-operative day two her chest tubes were removed. she was gently diuresed. she experienced atrial fibrillation and converted to sinus rhythm on amiodarone and beta blockers. on the following day she was transferred to the surgical step down floor and her epicardial wires were removed. she was seen in consultation by physical therapy. her beta blockade was tirated upward as tolerated. her diuretic regimen was increased due to a wet chest radiograph. the patient developed atrial fibrillation again on pod 6. her blood pressure remained stable, and she was asymptomatic. beta blocker and amiodarone were adjusted accordingly. coumadin was started for a goal inr 2.0. she was discharged to rehab in good condition on pod 6. medications on admission: lasix 160mg daily lisinopril 5mg daily metoprolol 25mg zocor 10mg daily aspirin 325mg daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 4. simvastatin 10 mg tablet sig: one (1) tablet po once a day. 5. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 8. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours). 10. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed). 11. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day): hold for sbp<90, hr<60. 12. amiodarone 200 mg tablet sig: two (2) tablet po tid (3 times a day): 400mg 3x/day for 1 week, then 400mg 2x/day for 1 week, then 200mg 2x/day for 1 week, then 200mg/day until further instructed. 13. warfarin 1 mg tablet sig: three (3) tablet po once a day: for atrial fibrillation, titrate daily for goal inr 2.0. 14. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 15. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po bid (2 times a day). discharge disposition: extended care facility: lifecare of discharge diagnosis: aortic stenosis 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 no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr in 4 weeks () please call for appointment dr (pcp) in 1 week ( please call for appointment dr in weeks (cardiology) please call for appointment procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation aortic valve disorders chronic diastolic heart failure long-term (current) use of aspirin 

Answer: The patient is high likely exposed to