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: sulfa (sulfonamide antibiotics) / amoxicillin attending: chief complaint: cerebral vascular accident major surgical or invasive procedure: redosternotomy mitaral valve replacement #25 tissue valve history of present illness: mrs. is an 85 yo female s/p mv repair on who has had multiple tias this year with 6 just since . she had a stroke in that lasted for 12 hrs. most recent was fri the 12th with l sided weakness/numbness that last 45 minutes. also in she had pe and ivc filter. she has been on coumadin for the pe and has had a stroke when her inr was suprathrapeutic. she has undergone considerable work-up, including echo. echo revealed small mass (thrombus vs vegetation). blood cultures were negative. dr. saw the patient in and determined that surgical risk outweighed benefit given her age and redo status. she has subsequently been admitted to an outside hospital. echo reveals an increase in size and complexity of the mass. she remains afebrile with negative blood cultures and no stigmata of endocarditis. she is transferred for surgical evaluation. past medical history: mitral regurgitation h/o acute diastolic heart failure chronic atrial fibrillation h/o deep vein thrombosis osteoarthritis of left knee with dislocated joint spinal stenosis hypertension left hip bursitis renal calculi s/p tonsillectomy s/p repair left wrist fracture s/p total abdominal hysterectomy s/p bilateral cataract surgery social history: race: caucasian last dental exam: lives with:husband occupation:retired school nurse tobacco: denies etoh: denies family history: father ?mi, grandfather deceased from mi at 65 physical exam: pre-op physical exam pulse: 65 sr resp: 15 o2 sat: 100% b/p right: 120/60 left: height: weight: 71.6 kg general: nad, conversant skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender + bs extremities: warm , well-perfused edema __1+ no splinter hemorrhages, -way lesions. varicosities: none neuro: grossly intact x pulses: femoral right: 2 left:2 dp right: 2 left:2 pt : 2 left:2 radial right: 2 left:2 carotid bruit right: x left:x discharge exam: vs t97.2 hr 71 afib bp 127/76 rr 18 o2sat 99% ra wt 77.8kg gen: nad neuro: a&ox3, mae. nonfocal exam pulm: diminished left base cv: irreg irreg, sternum stable, incision-cdi abdm: soft, nt/nabs ext: warm, well perfused. 1+ bilat le edema pertinent results: admission labs: 09:00pm pt-23.0* ptt-37.5* inr(pt)-2.1* 09:00pm plt count-342 09:00pm wbc-6.5 rbc-4.50# hgb-13.7# hct-40.0# mcv-89 mch-30.5 mchc-34.3 rdw-12.7 09:00pm albumin-4.0 calcium-8.7 phosphate-2.5* magnesium-1.9 09:00pm lipase-57 09:00pm alt(sgpt)-18 ast(sgot)-23 ld(ldh)-251* alk phos-117* amylase-139* tot bili-0.4 09:00pm glucose-113* urea n-13 creat-0.6 sodium-136 potassium-3.7 chloride-103 total co2-26 anion gap-11 discharge labs: 05:15am blood wbc-8.2 rbc-3.41* hgb-10.5* hct-31.5* mcv-92 mch-30.7 mchc-33.2 rdw-14.8 plt ct-236# 06:50am blood pt-27.7* inr(pt)-2.5* 05:15am blood plt ct-236# 05:15am blood pt-15.7* inr(pt)-1.4* 06:50am blood urean-15 creat-0.7 na-131* k-4.1 cl-100 05:15am blood glucose-96 urean-14 creat-0.6 na-135 k-4.4 cl-100 hco3-27 angap-12 06:50am blood mg-2.0 tee pre-cpb: 1 the left atrium is moderately dilated. no spontaneous echo contrast is seen in the body of the left atrium. the left atrial appendage emptying velocity is depressed (<0.2m/s). no thrombus is seen in the left atrial appendage. 2. left ventricular wall thicknesses and cavity size are normal. 3. right ventricular chamber size and free wall motion are normal. 4. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. there are simple atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. mild to moderate (+) aortic regurgitation is seen. 6. a mitral valve annuloplasty ring is present. at least 2 vegetations seen on the anterior and posterior leaflets. there is severe valvular mitral stenosis (area <1.0cm2). due to co-existing aortic regurgitation, the pressure half-time estimate of mitral valve area may be an overestimation of true mitral valve area. mitral valve area was calculated at 0.8-0.9 cm2. there is moderate functional mitral stenosis (mean gradient 5 mmhg) due to mitral annular calcification. mild (1+) mitral regurgitation is seen. 7. there is no pericardial effusion. drs. and were notified in person of the results. post-cpb: on infusion of phenylephrine. av pacing for prolonged pr interval. well seated bioprothetic valve in the mitral postion. small inferiolateral perivalvular leak. small central leak. peak gradient 5 mmhg, mean gradient 4 mmhg at cardiac output of 2.5. preserved biventricular systolic function. ai and tr remain +. aortic contour normal post-decannulation. . radiology report chest (portable ap) study date of 9:48 am final report: since the prior exam, the bilateral chest tubes have been removed. there are very small bilateral apical pneumothoraces, slightly larger on the right than left. the right pneumothorax measures approximately 12 mm and the left approximately 7 mm. there is no evidence of tension. bibasilar atelectasis is unchanged. there is no definite pleural effusion. there is no pulmonary edema. severe cardiomegaly is stable. the mediastinal contours are unchanged. sternal wires are intact. mediastinal clips are noted. impression: 1. small biapical pneumothoraces after chest tube removal. 2. stable bibasilar atelectasis. 3. stable severe cardiomegaly. the study and the report were reviewed by the staff radiologist. dr. chest ct from - per verbal report: no official reead at this time. right upper lobe opacity measuring 16x2cm likely hematoma but cannot be sure. substernal fluid collection measuring 6x2cm likely normal post-op changes recommend: followup ct in 6 weeks brief hospital course: the patient was transferred from outside hospital after several tia's. she had known mitral valve mass vs vegetation and was preop for redo mitral valve replacement. she brought to the operating room on and underwent mitral valve replacement, please see operative report for details in summary she had: redo sternotomy and redo mitral valve surgery with mitral valve replacement with a . medical bicor epic tissue heart valve. her bypass time was 80 minutes with a crossclamp time of 61 minutes. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu intubated on levophed and propofol. she initally had moderate amount of bleeding and required products, she began to manifest tampanade physiology, an echo was performed which confirmed tamponade. she returned to the operating room for exploration and removal of clot and correction of coagulopathy. see operative notes for details. once returning from the or she was hemodynamically stable and levophed infusion was weaned. she continue to have moderate chest tube drainage and was given additional red blood cells and platelets on pod#1. her bleeding resolved and she was extubated on pod#1 without difficulty. once extubated he was alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. low dose beta blocker was initiated at first due to bradycardia and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery on pod2. chest tubes and pacing wires were discontinued per cardiac surgery protocol without complication. the remainder of her hospital course was uneventful, she was worked with nursing and physical therapy services for assistance with strength and mobility. by the time of discharge on pod7 the patient was ambulating with assistance the wound was healing and pain was controlled with oral analgesics. the patient was discharged to in in good condition with appropriate follow up instructions. she is to follow up with dr in 1 month. medications on admission: atorvastatin 20mg daily cardizem cd 120mg daily furosemide 40mg daily toprol xl 50mg daily pantoprazole 40mg daily kcl 40meq daily warfarin 2mg daily aspirin 81mg daily calcium carbonate 500mg daily vit d3 1,000 units daily magnesium chloride (slow mag) 64mg mvi daily discharge medications: 1. aspirin ec 81 mg po daily 2. atorvastatin 20 mg po daily 3. calcium carbonate 500 mg po daily 4. multivitamins 1 tab po daily 5. pantoprazole 40 mg po q24h 6. vitamin d 1000 unit po daily 7. warfarin md to order daily dose po daily target inr 2-3.0 8. acetaminophen 650 mg po q4h:prn pain 9. amiodarone 400 mg po daily 400mg daily x 1 week then 200mg daily 10. bisacodyl 10 mg pr daily:prn constipation 11. docusate sodium 100 mg po bid 12. furosemide 40 mg po daily 13. metoprolol tartrate 25 mg po tid 14. milk of magnesia 30 ml po daily 15. tramadol (ultram) 50 mg po q6h:prn pain 16. slow-mag *nf* (magnesium chloride) 64 oral 17. potassium chloride 20 meq po q12h discharge disposition: extended care facility: discharge diagnosis: s/p redo sternotomy/mitral valve replacement/excision of mitral valve mass pmh: acute diastolic heart failure admission , mitral regurgitation, atrial fibrillation cardioverted , deep vein thrombosis, osteoarthritis left knee with dislocated joint, spinal stenosis, hypertension, left hip bursitis, renal calculi, mitral valve repair , tonsillectomy, orif left wrist fracture, total abdominal hysterectomy, bilateral cataracts discharge condition: alert and oriented x3 nonfocal ambulating, with assistance sternal pain managed with ultram and tylenol incision: sternum-healing well no erythema or drainage edema: 1+ bilateral le discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 one month or while taking narcotics. 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 followup instructions: please call to schedule appointments surgeon dr. at 1:15p cardiologist dr. at 12:45p primary care dr. ( in weeks **will need follow-up ct chest in 6 weeks to assess opacity in right upper lobe* **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 coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart reopening of recent thoracotomy site open and other replacement of mitral valve with tissue graft diagnoses: abnormal coagulation profile mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation other complications due to heart valve prosthesis hemorrhage complicating a procedure chronic systolic heart failure long-term (current) use of anticoagulants personal history of venous thrombosis and embolism personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation cerebral embolism with cerebral infarction cardiac tamponade personal history of pulmonary embolism other restorative surgery causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation osteoarthrosis, localized, not specified whether primary or secondary, lower leg other venous embolism and thrombosis of unspecified site 

Answer: The patient is high likely exposed to