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 / vicodin / novocain / percocet / influenza virus vaccine attending: chief complaint: decreased exercise tolerance major surgical or invasive procedure: 1. aortic valve replacement with 21-mm st. medical biocor tissue valve. 2. coronary artery bypass grafting x1 with reverse saphenous vein graft to diagonal branch. history of present illness: this is a 75 year old female with known bicuspid aortic valve and aortic stenosis who has been followed by serial echocardiograms. with decreased exercise tolerance and presenting today for cardiac catherization and admission for surgery. past medical history: bicuspid aortic valve, severe aortic stenosis hypertension gastroesophageal reflux disease degenerative joint disease past surgical history: oral surgery (implants), d&c social history: race: hispanic last dental exam: clearance in chart lives: alone, plans to stay with a friend post-surgery occupation: tobacco: quit 30 years ago; 10 pyhx etoh: social, no history of abuse family history: mi in her father at age 62; sister with cardiomyopathy physical exam: admission physical exam pulse:84 resp:18 o2 sat: 100% b/p right:159/90 left: 171/90 height:5'2" weight:174 # general no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur- 3/6 sem abdomen: obese,soft non-distended non-tender bowel sounds + no palpable masses extremities: warm , well-perfused edema- none varicosities: none neuro: grossly intact, strengths, nonfocal exam pulses: femoral right:1+ left:1+ dp right:1+ left:1+ pt :1+ left:1+ radial right:2+ left:2+ carotid bruit : murmur radiates to bilateral carotids pertinent results: 06:40am blood hct-26.6* 09:41am blood wbc-5.5 rbc-4.44 hgb-13.7 hct-39.3 mcv-88 mch-30.9 mchc-35.0 rdw-13.9 plt ct-283 12:34pm blood pt-15.0* ptt-34.7 inr(pt)-1.3* 09:41am blood pt-13.1 ptt-33.1 inr(pt)-1.1 06:40am blood urean-19 creat-0.9 na-138 k-3.8 cl-95* 09:41am blood glucose-107* urean-17 creat-0.9 na-140 k-4.1 cl-103 hco3-28 angap-13 echocardiography report , (complete) done at 10:10:31 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 75 f hgt (in): 62 bp (mm hg): / wgt (lb): 183 hr (bpm): bsa (m2): 1.84 m2 indication: aortic valve disease. coronary artery disease. intraoperative tee for avr + cabg icd-9 codes: 402.90, 424.1 test information date/time: at 10:10 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 #: 2010aw1-: machine: ie33 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.0 cm <= 5.6 cm left ventricle - systolic dimension: 3.0 cm left ventricle - fractional shortening: 0.40 >= 0.29 left ventricle - ejection fraction: 55% to 60% >= 55% left ventricle - stroke volume: 53 ml/beat aorta - annulus: 2.3 cm <= 3.0 cm aorta - sinus level: 3.0 cm <= 3.6 cm aorta - sinotubular ridge: 2.2 cm <= 3.0 cm aorta - ascending: *3.9 cm <= 3.4 cm aorta - arch: 2.3 cm <= 3.0 cm aorta - descending thoracic: 2.3 cm <= 2.5 cm aortic valve - peak velocity: *3.5 m/sec <= 2.0 m/sec aortic valve - peak gradient: *49 mm hg < 20 mm hg aortic valve - mean gradient: 30 mm hg aortic valve - lvot pk vel: 0.70 m/sec aortic valve - lvot vti: 14 aortic valve - lvot diam: 2.2 cm aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 mitral valve - mva (p t): 3.5 cm2 mitral valve - e wave: 0.7 m/sec mitral valve - a wave: 0.6 m/sec mitral valve - e/a ratio: 1.17 findings left atrium: no spontaneous echo contrast or thrombus in the body of the laa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: mild symmetric lvh. normal lv cavity size. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated ascending aorta. normal aortic arch diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: bicuspid aortic valve. critical as (area <0.8cm2). no ar. mitral valve: no ms. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. tricuspid valve not well visualized. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pulmonic valve not well seen. 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. results were personally reviewed with the md caring for the patient. conclusions pre cpb: no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is mild 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 ascending aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve appears to be bicuspid with a raphe between the left coronary cusp and right coronary cusp. there is critical aortic valve stenosis (valve area <0.8cm2). no aortic regurgitation is seen. trivial mitral regurgitation is seen. many of the views in this exam were difficult to obtain due to the spatial relationship between the esophagus and the rest of the heart. dr. was notified in person of the results. post cpb: the patient is on no inotropes. a bio-prosthetic aortic valve is well-seated with no ai and no leak. residual mean gradient = 7 mmhg. trace mr. preserved biventricular systolic fxn. aorta intact. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 14:25 ?????? caregroup is. all rights reserved. brief hospital course: ms. was taken to the operating room and underwent aortic valve replacement with 21-mm st. medical biocor tissue valve/coronary artery bypass grafting x1 with reverse saphenous vein graft to diagonal branch with dr.. please refer to operative report for further surgical details. she tolerated the procedure well and was transferred to the cvicu intubated, sedated in critical but stable condition. she awoke neurologically intact and was extubated without difficulty. weaned off all drips. beta-blocker/statin/asa and diuresis was initiated. pod# 1 she was transferred to the step down unit for further monitoring. physical therapy was consulted for strength and mobility evaluation. the remainder of her hospital admisssion was essentially uneventful. on pod#5 she was cleared for discharge to rehabilitation in . all follow up appointments were advised. medications on admission: metoprolol succinate 25mg daily aspirin 81mg daily discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 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. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 6. furosemide 20 mg tablet sig: one (1) tablet po once a day for 1 weeks. 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. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 10. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). 11. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: newbridge on the - discharge diagnosis: 1. aortic valve replacement with 21-mm st. medical biocor tissue valve. 2. coronary artery bypass grafting x1 with reverse saphenous vein graft to diagonal branch pmh: bicuspid aortic valve, severe aortic stenosis hypertension gastroesophageal reflux disease degenerative joint disease past surgical history: oral surgery (implants), d&c discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr. # an appointment was arranged for at 1:30pm cardiologist:dr. on at 8am please call to schedule appointments with your primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization coronary arteriography using a single catheter (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension personal history of tobacco use osteoarthrosis, unspecified whether generalized or localized, site unspecified congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to