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: iodine-iodine containing / vancomycin analogues / amoxicillin / demerol / oxybutynin / levofloxacin / simvastatin attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement with a 23 mm magna ease pericardial tissue valve, model number 3300tfx, serial number history of present illness: this is a 58 year old female who has undergone serial echocardiograms for many years for bicupsid aortic valve. she has recently been experiencing new exertional dyspnea. she also experiences a burning sensation in her chest concurrently with the dyspnea both of which resolve with rest. her repeat echocardiogram in confirmed progression of her aortic stenosis with a calculated valve area of 0.6cm and peak/mean gradients of 70 and 43mmhg. she presents today for surgical evaluation. she currently denies syncope, pre- syncope, palpitations, orthopnea, pnd and pedal edema. past medical history: -aortic stenosis - complete heart block s/p ddd ppm - pacemaker dependent per patient - hypertension - remote episode of paroxsymal atrial fibrillation - history of transitional cell carcinoma - primary biliary cirrhosis, recent biopsy done for surgical clearance - varicose veins, right leg worse than left leg - history of partial small bowel obstruction(many years ago) - recurrent uti's, patient requires self cath q 2 hours. typically treated with ciprofloxacin. - mild renal insufficiency(cr 1.3), s/p right nephrectomy s/p cystectomy with neobladder, hysterectomy s/p right nephrectomy s/p right cataract surgery s/p lap chole s/p appendectomy social history: race: caucasian last dental exam: every 6 months; clearance received in office lives alone; sister nearby occupation: administrator at cigarettes: never etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: never family history: denies premature coronary artery disease father with lung cancer. physical exam: bp: 145/85 pulse: 76 resp: 16 o2 sat: 100% room air height: 71" weight: 202 lbs general: wdwn female in no acute distress. alert and oriented. appropriate mood. skin: dry intact heent: perrla eomi anicteric sclera, op unremarkable neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade 4/6 sem radiating to carotids bilaterally abdomen: soft non-distended non-tender bowel sounds + ; well-healed scars extremities: warm , well-perfused edema: none varicosities: greater saphenous vein appeared ok. large varicosities noted anteriorly(right worse than left) neuro: grossly intact pulses: femoral right: 2 left: 2 dp right: 1 left: 1 pt : 1 left: 1 radial right: 2 left: 2 carotid bruit: transmitted murmurs b pertinent results: echo : pre-bypass: no spontaneous echo contrast 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. 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 ascending aorta is mildly dilated. the aortic arch is mildly dilated. the aortic valve is bicuspid with a vertical commissure. 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 mildly thickened. mild mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results at time of surgery. post-bypass: the patient is on no inotropes. biventricular function is unchanged. there is a well-seated, well-functioning bioprosthetic valve in the aortic position. there is no aortic regurgitation. no paravalvular leak is seen. there is a gradient of 7 mmhg across the aortic valve at a cardiac output of 5.0 l/min. the aorta is intact post-decannulation. cxr: the patient is status post sternotomy, with mild prominence of the cardiomediastinal silhouette. a left-sided dual-lead pacemaker is present, with lead tips over the right atrium and right ventricle. there is patchy increased retrocardiac opacity consistent with left lower lobe collapse and/or consolidation and probable small left effusion. there is minimal blunting of the right costophrenic angle and minimal atelectasis at the right base. no chf. curvilinear lucency adjacent to the left hilum is noted, ? some pericardial or, less likely, mediastinal emphysema. there is a small left apical pneumothorax, better seen and slightly larger than on . a small amount of free air is seen under the right hemidiaphragm, unchanged. cxr decrease in left apical pneumothorax wbc-7.8 rbc-3.24* hgb-10.3* hct-30.2* mcv-93 mch-31.8 mchc-34.1 rdw-13.7 plt ct-162 glucose-92 urean-24* creat-1.2* na-138 k-3.9 cl-102 hco3-28 mg-2.1 bc x 2 with no growth to date urine cx final no growth brief hospital course: ms. was a same day admit and on was brought directly to the operating room where she underwent an aortic valve replacement. please see operative note for surgical details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. several hours later she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was started on beta-blockers, diuretics and gently diuresed towards her pre-op weight. later this day she was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. cardiac: ddd-ppm was interrogated. beta-blockers were continued. she v-paced 50-90's. respiratory: aggressive pulmonary toilet continued. she titrated off oxygen with room saturations of 98%. gi: benign. tolerated a regular diet. renal: foley remained since the patient was unable to resume self catheterization immediately postoperative. her renal function remained within normal limits with good urine output. electrolytes were replete as needed. neuro: awake, alert oriented. dilaudid as needed for pain. disposition: seen by physical therapy who deemed her safe for home. she was discharged on and will follow-up as an outpatient. medications on admission: atenolol - 50 mg tablet - 1 (one) tablet(s) by mouth once a day catheter - - use size 10 fr for self urinary catheterization as directed dx: transitional cell ca of the bladder, s/p cystectomy and creation of neobladder icd9: 188.0 eflornithine - 13.9 % cream - apply to skin once a day fluticasone - 50 mcg spray, suspension - 1 spray(s) each nostril twice a day hydrochlorothiazide - 25 mg tablet - 0.5 (one half) tablet(s) by mouth once a day ursodiol - 300 mg capsule - 2 capsule(s) by mouth twice a day aspirin - 81 mg tablet, chewable - 1 (one) tablet, chewable(s) by mouth once a day cholecalciferol (vitamin d3) - (prescribed by other provider) - 400 unit capsule - capsule(s) by mouth once a day alertating days between 1 and 2 tablests discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. ursodiol 300 mg capsule sig: two (2) capsule po bid (2 times a day). 4. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 5. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 6. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 7. hydromorphone 2 mg tablet sig: one (1) tablet po every hours as needed for pain. disp:*50 tablet(s)* refills:*0* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. potassium chloride 10 meq capsule, extended release sig: one (1) capsule, extended release po daily (daily). disp:*7 capsule, extended release(s)* refills:*2* 10. furosemide 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* discharge disposition: home with service facility: vna of southeastern mass. discharge diagnosis: aortic stenosis s/p aortic valve replacement - complete heart block s/p ddd ppm - pacemaker dependent per patient - hypertension - remote episode of paroxsymal atrial fibrillation - history of transitional cell carcinoma - primary biliary cirrhosis, recent biopsy done for surgical clearance - varicose veins, right leg worse than left leg - history of partial small bowel obstruction(many years ago) - recurrent uti's, patient requires self cath q 2 hours. typically treated with ciprofloxacin. - mild renal insufficiency(cr 1.3), s/p right nephrectomy s/p cystectomy with neobladder, hysterectomy s/p right nephrectomy s/p right cataract surgery s/p lap chole s/p appendectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema 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: please call monday for a follow-up with dr. and the clinic. cardiologist: dr. please call the office for a follow-up appointment in weeks 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 open and other replacement of aortic valve with tissue graft diagnoses: anemia, unspecified unspecified essential hypertension aortic valve disorders pulmonary collapse iatrogenic pneumothorax other acquired absence of organ unspecified disorder of kidney and ureter personal history of malignant neoplasm of bladder cardiac pacemaker in situ congenital insufficiency of aortic valve acquired absence of kidney pain in joint, shoulder region acquired absence of both cervix and uterus biliary cirrhosis personal history, urinary (tract) infection acquired absence of organ, other parts of urinary tract asymptomatic varicose veins 

Answer: The patient is high likely exposed to