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: no known allergies / adverse drug reactions attending: chief complaint: aortic stenosis major surgical or invasive procedure: aortic valve replacement (21mm st. porcine tissue) history of present illness: this 76 year old white female has been folowed by cardiology for known aortic stenosis for some time. she has recently had worsening dyspnea and fatigue, echocardiograms have revealed aortic valve area now to be 0.7. catheterization was negative for coronary disease and elective valve replacement was scheduled now. past medical history: pulmonary fibrosis depression hypothyroidism right leg claudication hypertension hyperlipidemia s/p rectal polypectomy s/p excision skin cancer s/p tonsillectomy social history: race:caucasian last dental exam: edentulous lives with:alone; son in , daughter in contact: phone # occupation: retired telephone operator cigarettes: smoked no yes hx: quit 5 yrs ago; 45-50 pyhx other tobacco use:none etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: none family history: family history: no premature coronary artery disease father mi < 55 mother < 65 physical exam: pulse:75 o2 sat: 97% b/p right: 176/98 left: 179/88 (pt states she is nervous and bp was 130/70 at home this morning) height: 67" weight: 179 lbs general:nad skin: dry intact small scar on forehead heent: perrla eomi anicteric sclear, op unremarkable neck: supple full rom ; no appreciable jvd chest: lungs clear bilaterally heart: rrr irregular murmur grade ___4/6 sem radiates throughout chest to carotids___ abdomen: soft non-distended non-tender bowel sounds + no hsm/cva tenderness extremities: warm , well-perfused edema none_____ varicosities: none neuro: grossly intact ;nonfocal exam, mae strengths pulses: femoral right: 2+ left:2+ dp right: np left:np pt : np left:np radial right: 2+ left:2+ carotid bruit : murmur radiates to carotids pertinent results: 12:05pm blood wbc-8.7 rbc-3.25* hgb-9.5* hct-27.9*# mcv-86 mch-29.2 mchc-34.1 rdw-14.0 plt ct-115* 12:05pm blood pt-13.4* ptt-29.9 inr(pt)-1.2* 10:20am blood urean-27* creat-1.1 na-135 k-4.3 cl-97 12:05pm blood urean-18 creat-0.9 na-137 k-3.9 cl-109* hco3-23 angap-9 echocardiography report , (complete) done at 10:05:29 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 76 f hgt (in): 67 bp (mm hg): 134/67 wgt (lb): 178 hr (bpm): 78 bsa (m2): 1.93 m2 indication: inraoperative tee for avr. aortic valve disease. chest pain. hypertension. left ventricular function. mitral valve disease. preoperative assessment. prosthetic valve function. right ventricular function. valvular heart disease. icd-9 codes: 786.05, 424.1, 424.0, 424.2 test information date/time: at 10:05 interpret md: , md test type: tee (complete) son: , md doppler: limited doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: suboptimal tape #: 2011aw3-: machine: u/s 3 echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 55% >= 55% aorta - annulus: 2.0 cm <= 3.0 cm aorta - sinus level: 2.7 cm <= 3.6 cm aorta - ascending: 3.0 cm <= 3.4 cm findings right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. aortic valve: severely thickened/deformed aortic valve leaflets. severe as (area 0.8-1.0cm2). mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. moderate mitral annular calcification. mild (1+) 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 no atrial septal defect is seen by 2d or color doppler. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. mild (1+) mitral regurgitation is seen. dr. was notified in person of the results on /2011at 930 am. probe not advanced beyond ge junction as ? epiphrenic hernia. hence no transgastric views. post bypass patient is av paced and receiving an infusion of phenylephrine. bioprosthetic valve in aortic position. unable to assess due to no transgastric views. mild mitral regurgitation persists. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 16:22 ?????? caregroup is. all rights reserved. brief hospital course: following same day admission she was taken to the operating room where she underwent (#21mm porcine) aortic valve replacement with dr.. please refer to operative report for further details. cardiopulmonaryt bypass time= 67 minutes. cross clamp time=47 minutes. she weaned from bypass easily with atrial pacing and neo synephrine. she tolerated the procedure well and was transferred to the cvicu intubated and sedated. she remained stable after icu admission, awoke intact, weaned from the ventilator and was extubated. her pressor was weaned off. her cxr revealed vascular congestion on top of her underlying pulmonary disease and a dose of lasix was given with good result. beta blockade and further diuresis were begun the morning after surgery. cts and pacing wires were removed per protocol. pod#1 she was transferrd to the step down unit for further monitoring. physical therapy was consulted for evaluation of her mobility and strength. on pod#2 the patient's epicardial wires were discontinued without complication. now on pod #5, she continued to progress well, pain was well controlled, tolerating a regular diet, and she was diuresed to her peroperative weight. mr will be discharged to rehabilitation center on . arrangements were made for follow up with surgery, cardiology and her primary care physicians. medications on admission: effexor xr 75mg daily triamterence-hctx 37.5/25mg daily remeron 15mg at bedtime risperdal 0.25mg at bedtime aspirin 81mg daily simvastatin 20mg daily calcium acetate 250mg daily discharge medications: 1. venlafaxine 75 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po once a day. 2. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 3. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever or pain. 6. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 7. venlafaxine 75 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po daily (daily). 8. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 10. risperidone 0.25 mg tablet sig: one (1) tablet po hs (at bedtime). 11. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. disp:*30 capsule(s)* refills:*2* 14. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*2* 15. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day): hold for sbp <100 or hr <60. disp:*90 tablet(s)* refills:*2* 16. lasix 40 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 17. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po once a day for 7 days. disp:*7 tablet, er particles/crystals(s)* refills:*0* discharge disposition: extended care facility: tba discharge diagnosis: s/p aortic valve replacement aortic stenosis pulmonary fibrosis hypothyroidism depression hyperlipidemia hypertension s/p rectal polypectomy s/p tonsillectomy s/p excision skin cancer discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage edema:trace 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. () on at 1pm cardiologist:dr. () on at2pm please call to schedule appointments with: 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 open and other replacement of aortic valve with tissue graft diagnoses: unspecified essential hypertension unspecified acquired hypothyroidism aortic valve disorders depressive disorder, not elsewhere classified personal history of other malignant neoplasm of skin postinflammatory pulmonary fibrosis 

Answer: The patient is high likely exposed to