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: bee stings / hornets attending: chief complaint: asymptomatic major surgical or invasive procedure: aortic valve replacement (23mm tissue), ascending aorta replacement (30mm gelweave) history of present illness: mr. is a 67 year old gentleman with history of bicuspid aortic stenosis which has been followed by serial echocardiograms. his most recent echocardiogram revealed that the valve area had decreased to 0.7cm2 and his ascending aortic aneurysm had increased to 4.6cm. he is essentially asymptomatic from a cardiac standpoint. he has now been referred for surgical management. past medical history: bicuspid aortic valve stenosis, ascending aortic aneurysm, hypertension, hyperlipidemia, transitional cell cancer of ureter - chemotherapy, left nephrectomy , appendectomy social history: mr. works in refrigerator repair and is a school bus driver. his most recent cigarette was and he reports smoking 1 pack per day for over 50 years. he drinks less than 1 alcoholic drink per week. etoh: < 1 drink/week drinks/week >8 drinks/week family history: non-contributory physical exam: pulse: 76 resp: 16 o2 sat: 100 b/p right: 174/99 left: 175/101 weight: 175 general: nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade _3/6 systolic__ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _none_ varicosities: none mild-moderate 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:radiation of cardiac murmur pertinent results: echocardiography report , (complete) done at 9:29:10 am preliminary referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 67 m hgt (in): 70 bp (mm hg): 167/89 wgt (lb): 180 hr (bpm): 72 bsa (m2): 2.00 m2 indication: intraoperative tee for avr and ascending aorta replacement. aortic valve disease. left ventricular function. mitral valve disease. preoperative assessment. prosthetic valve function. right ventricular function. valvular heart disease. icd-9 codes: 786.05, 786.51, 424.1, 424.0, 424.2 test information date/time: at 09:29 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/s3 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - ejection fraction: 55% >= 55% aorta - sinus level: *3.8 cm <= 3.6 cm aorta - ascending: *4.2 cm <= 3.4 cm aortic valve - valve area: *0.8 cm2 >= 3.0 cm2 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: mild symmetric lvh with normal cavity size. mild symmetric lvh. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: mildy dilated aortic root. mildly dilated ascending aorta. simple atheroma in aortic arch. simple atheroma in descending aorta. aortic valve: bicuspid aortic valve. severe as (area 0.8-1.0cm2). mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: mild tr. 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. conclusions prebypass no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild symmetric left ventricular hypertrophy. 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 root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve is bicuspid. 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 (1+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results on at 830 am. poor mid esophageal views prebypass post bypass patient is a paced and receiving an infusion of phenylephrine. unable to obtain any images in the midesophagus. limited imaging of the left ventricle from the transgastric views. unable to evaluate the valve or aorta. dr aware of this issue. note- easy atraumatic placement of the tee probe. brief hospital course: on mr. an aortic valve replacement (23mm tissue), ascending aorta replacement (30mm gelweave) performed by dr. . please see the operative note for details. he was placed on nicardipine for blood pressure control. he was extubated on the same day of surgery. on the following day chest tubes were removed and his cordis was changed over a wire to a triple lumen. temporary pacing wires were removed per protocol. he was started on betablockers, statin and gently diuresed toward his pre-operative weight. he was evaluated by physical therapy for strength and conditioning and discharge to rehab was recommended. on pod# 5 he was cleared for discharge to home. medications on admission: atenolol 50mg daily lisinopril 20mg daily aspirin 81mg daily lovastatin 20mg qhs discharge medications: 1. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 2. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 3. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*70 tablet(s)* refills:*0* 4. 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:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain, fever. 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 weeks. disp:*28 tablet(s)* refills:*0* 9. lasix 40 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 10. potassium chloride 20 meq packet sig: one (1) po once a day for 2 weeks. disp:*14 packets* refills:*0* 11. lovastatin 20 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po at bedtime. disp:*30 tablet extended release 24 hr(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: aortic stenosis, dilated aorta bicuspid aortic valve stenosis, asc. aortic aneurysm, hypertension, hyperlipidemia, transitional cell cancer of ureter - chemotherapy, left nephrectomy ,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+ 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 **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: 1:45pm in the medical office building, , ma cardiologist: dr. at 9:15am 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: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels diagnoses: thrombocytopenia, unspecified unspecified essential hypertension acute posthemorrhagic anemia thoracic aneurysm without mention of rupture personal history of tobacco use other and unspecified hyperlipidemia hypoxemia congenital insufficiency of aortic valve acquired absence of kidney examination of participant in clinical trial personal history of malignant neoplasm of other urinary organs 

Answer: The patient is high likely exposed to