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 attending: chief complaint: shortness of breath major surgical or invasive procedure: aortic valve replacement (19mm porcine), coronary artery bypass grafting times three history of present illness: ms. is a 82 year old female with known aortic stenosis. after she underwent a cardiac catheterization at medical center on which showed multi-vessel coronary artery disease, she was deemed not to be a good surgical candidate due to heavily calcified aorta. therefore, she was discharged home with medical management. shortly after being home she developed worsening shortness of breath and was admitted to on . she was referred from there to the cardiac surgery service for consideration of an aortic valve replacement and coronary artery bypass grafting. past medical history: congestive heart failure related to severe aortic stenosis, hypertension, hyperlipidemia, reflux, transitory ischemic attacks, osteoarthritis, carotid stenosis, hyperlipidemia, hammer toes right foot, callus right foot, right hip replacement times two, left hip replacement, right knee replacement, hysterectomy, appendectomy, tonsillectomy and adenoidectomy social history: ms. lives independently at home in after husband died in . she denies a smoking history and any alcohol or illicit drug use. family history: non-contributory physical exam: pulse:74 resp: 14 o2 sat: 100 on 3l b/p right: 158/75 left:151/65 height:5ft weight:114lbs five meter walk test #1_______ #2 _________ #3_________ general: skin: dry intact heent: perrla eomi neck: supple full rom stiff neck chest: lungs clear bilaterally heart: rrr irregular murmur grade _4/6_____ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema none_____ varicosities: none neuro: grossly intact pulses: femoral right:+1 left:+1 dp right: +1 left:+1 pt : +1 left:+1 radial right: +2 left:+2 carotid bruit right: positive left:positive pertinent results: echocardiography report , (complete) done at 1:10:41 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 83 f hgt (in): 60 bp (mm hg): 180/90 wgt (lb): 114 hr (bpm): 73 bsa (m2): 1.47 m2 indication: aortic valve replacement, cabg icd-9 codes: 424.1, 424.0, 424.2 test information date/time: at 13:10 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 #: 2011aw1-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *6.0 cm <= 4.0 cm left atrium - four chamber length: *5.9 cm <= 5.2 cm left ventricle - septal wall thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.0 cm <= 5.6 cm left ventricle - ejection fraction: 55% >= 55% aorta - ascending: 2.8 cm <= 3.4 cm aortic valve - peak velocity: *3.8 m/sec <= 2.0 m/sec aortic valve - peak gradient: *55 mm hg < 20 mm hg aortic valve - mean gradient: 39 mm hg aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 findings left atrium: marked la enlargement. no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. right atrium/interatrial septum: normal ra size. pfo is present. left-to-right shunt across the interatrial septum at rest. left ventricle: mild symmetric lvh with normal cavity size and regional/global systolic function (lvef>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. normal ascending aorta diameter. simple atheroma in ascending aorta. focal calcifications in ascending aorta. normal aortic arch diameter. simple atheroma in aortic arch. focal calcifications in aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). trace ar. mitral valve: moderately thickened mitral valve leaflets. no mvp. moderate mitral annular calcification. moderate thickening of mitral valve chordae. moderate to severe (3+) mr. tricuspid valve: mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. 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. see conclusions for post-bypass data conclusions pre-bypass: the left atrium is markedly dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are focal calcifications in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is no mitral valve prolapse. there is moderate thickening of the mitral valve chordae. moderate to severe (3+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results before surgical incision.. post-bypass: normal rv systolic function. lvef 55%. stable prosthesis in the native aortic position, no perivalvular leaks and a mean gradient of 15 mm of hg across the aortic valve. moderate mr. . intact thoracic aorta brief hospital course: ms. was admitted on for a pre-operative work-up. she was diuresed with lasix. she was newly diagnosed as diabetic and given diabetic teaching. she was cleared for surgery by the dentistry service. she was treated for a urinary tract infection with ciprofloxacin. on she underwent an aortic valve replacement (19mm st. porcine), coronary artery bypass grafting times three (left internal mammary to left anterior descending, saphenous vein graft to diagonal and obtuse marginal), performed by dr. . please see the operative note for details. she tolerated the procedure well and was transferred in critical but stable condition to the intensive care unit. by the following day she was extubated and weaned from pressors. she required atrial pacing for blood pressure support initially, but this therapy was weaned by post-operative three, at which time she was hemodynamically stable with a sinus rhythm in the 70s. she experienced delirium which cleared over the ensueing days. she is anxious at baseline and tends to become tacypneic when she is anxious but responds well to reassurance. she was transferred to the surgical step down floor. she was started back on statin therapy, , betablocker and gently diuresed back to her pre-operative weight. she was evaluated by physical therpay for strength and conditioning and rehab was recommended upon discharge. on pod# 5 she was discharged to rehab in . all follow up appointments were advised. medications on admission: asa 81mg daily, atenolol 50mg daily, lipitor 40mg daily, vitamin c 1000mg daily, vit b 12 1000mcq daily, zetia 10mg daily, iron 325mg daily, diovan 320mg po daily, prilosec 20mg daily, lisinopril 5mg daily new discharge medications: 1. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 2. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day): dvt prophylaxis. 3. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for pain. 4. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 5. cholecalciferol (vitamin d3) 1,000 unit tablet : one (1) tablet po daily (daily). 6. ferrous sulfate 300 mg (60 mg iron) tablet : one (1) tablet po daily (daily). 7. cyanocobalamin (vitamin b-12) 500 mcg tablet : two (2) tablet po daily (daily). 8. ezetimibe 10 mg tablet : one (1) tablet po daily (daily). 9. atorvastatin 40 mg tablet : one (1) tablet po daily (daily). 10. magnesium hydroxide 400 mg/5 ml suspension : thirty (30) ml po hs (at bedtime) as needed for constipation. 11. bisacodyl 10 mg suppository : one (1) suppository rectal daily (daily) as needed for constipation. 12. metoprolol tartrate 50 mg tablet : one (1) tablet po three times a day. 13. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) inhalation q6h (every 6 hours) as needed for dypnea. 14. diovan 160 mg tablet : one (1) tablet po once a day: home dose 320mg-please titrate as tolerated. 15. potassium chloride 10 meq tablet extended release : four (4) tablet extended release po q12h (every 12 hours) for 2 weeks: while on lasix. 16. lasix 40 mg tablet : one (1) tablet po twice a day for 2 weeks: d/c when edema resloves and at pre-op weigth of 50kg. discharge disposition: extended care facility: aberjona nursing center - discharge diagnosis: aortic stenosis congestive heart failure related to severe ai, hypertensive, hyperlipidemia, gerd, tia, osteoarthritis, carotid stenosis, hyperlipidemia, hammer toes right foot, callus right foot, ?tia, rhr x2, lhr, rkr, hysterectomy,appendectomy 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. edema 1+ 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: you are scheduled for the following appointments surgeon: dr. date/time: 1:15in the medical office building . please call to schedule appointments with your primary care dr. ,dhiren k. in weeks cardiologist: dr. in 2 weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia osteoarthrosis, unspecified whether generalized or localized, site unspecified personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits acute diastolic heart failure knee joint replacement delirium due to conditions classified elsewhere hip joint replacement 

Answer: The patient is high likely exposed to