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: occasional sob major surgical or invasive procedure: avr(#23 mm tissue valve)() history of present illness: 60 yo m with history of heart murmur since his 20's, followed by serial echo which most recently showed a trileaflet av but functionally bicuspid valve with fused leaflets and severe ai. mri also showed severe as. cath showed no cad. he was referred for avr. past medical history: ai/as, depression, adhd, aspergers syndrome, bph, lbp social history: lives alone quit tobacco 15 years ago after 3 ppd sober for 23 years family history: ns physical exam: nad lungs ctab heart rrr 3/6 sem with radiation to carotids abdomen soft/nt/nd neuro grossly intact extrem warm, no edema pertinent results: 07:25am blood wbc-10.6 rbc-3.01* hgb-9.0* hct-26.4* mcv-88 mch-29.8 mchc-33.9 rdw-13.8 plt ct-326 07:25am blood plt ct-326 03:05am blood pt-12.5 ptt-32.9 inr(pt)-1.1 07:25am blood glucose-96 urean-13 creat-0.9 na-140 k-4.2 cl-105 hco3-25 angap-14 chest (pa & lat) 5:55 pm chest (pa & lat) reason: eval for effusions medical condition: 59 year old man s/p avr reason for this examination: eval for effusions history: status post avr, to evaluate for effusions. findings: in comparison with the study of , there is increasing left pleural effusion. there is also increase in the smaller right pleural effusion. mild atelectatic changes are seen at the bases in this patient who has undergone a previous median sternotomy. impression: no evidence of acute pneumonia. echocardiography report , (complete) done at 9:36:48 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 59 m hgt (in): 64 bp (mm hg): 128/76 wgt (lb): 145 hr (bpm): 58 bsa (m2): 1.71 m2 indication: intra-op tee for avr icd-9 codes: 440.0, 424.1 test information date/time: at 09:36 interpret md: , 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 #: 2008aw209-9:2 machine: echocardiographic measurements results measurements normal range left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.2 cm <= 5.6 cm left ventricle - systolic dimension: 2.7 cm left ventricle - fractional shortening: 0.36 >= 0.29 left ventricle - ejection fraction: 60% >= 55% aorta - annulus: 2.3 cm <= 3.0 cm aorta - sinus level: 3.4 cm <= 3.6 cm aorta - sinotubular ridge: 2.2 cm <= 3.0 cm aorta - ascending: 3.2 cm <= 3.4 cm aorta - arch: 2.5 cm <= 3.0 cm aorta - descending thoracic: *2.6 cm <= 2.5 cm aortic valve - peak velocity: *3.5 m/sec <= 2.0 m/sec aortic valve - peak gradient: *48 mm hg < 20 mm hg aortic valve - mean gradient: 21 mm hg aortic valve - lvot pk vel: 0.67 m/sec aortic valve - valve area: *0.7 cm2 >= 3.0 cm2 findings left atrium: good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra and extending into the rv. normal 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: normal aortic diameter at the sinus level. focal calcifications in aortic root. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. severe as (aova <0.8cm2). severe (4+) ar. eccentric ar jet. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. no ms. the mr vena contracta is <0.3cm. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. 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 the post-bypass study was performed while the patient was receiving vasoactive infusions (see conclusions for listing of medications). conclusions pre-bypass: 1. no atrial septal defect is seen by 2d or color doppler. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size 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 arch. there are simple atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). severe (4+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric. 6. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine and was in sinus rhythm. 1. a well-seated bioprosthetic valve is seen in the aortic position with normal leaflet motion and gradients (mean gradient = 10 mmhg). no aortic regurgitation is seen. 2. biventricular functions is preserved 3. aortic contours are intact post decannulation. 4. other findings are unchanged brief hospital course: he was taken to the operating room on 1.14 where he underwent an avr. he was transferred to the icu in stable condition. he was extubated on pod #1. he continued to require intermittent neo which was weaned to off by pod #2 and he was transferred to the floor. he did well postoperatively. he remained in the hospital after having a fever on pod #4. he was afebrile x 24 hours and was ready for discharge on pod #5. he complained of tooth pain and was started on penicillin and asked to follow upw ith his local dentist. medications on admission: ai/as, depression, adhd, aspergers syndrome, bph, lbp discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 4. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). disp:*30 capsule(s)* refills:*0* 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 7. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. chlordiazepoxide hcl 25 mg capsule sig: two (2) capsule po daily (daily). 9. lasix 20 mg tablet sig: one (1) tablet po twice a day for 5 days. disp:*10 tablet(s)* refills:*0* 10. penicillin v potassium 250 mg tablet sig: one (1) tablet po q6h (every 6 hours) for 1 weeks. disp:*28 tablet(s)* refills:*0* discharge disposition: home with service facility: hospice and vna discharge diagnosis: ai/as now s/p avr depression, adhd, aspergers syndrome, bph, lbp discharge condition: good. discharge instructions: call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. shower, no baths, no lotions, creams or powders to incisions. no lifting more than 10 pounds or driving until follow up with surgeon. p instructions: dr. 2 weeks dr. 2 weeks dr. 4 weeks procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft continuous intra-arterial blood gas monitoring diagnoses: aortic valve disorders other specified complications of procedures not elsewhere classified other specified disorders of the teeth and supporting structures 

Answer: The patient is high likely exposed to