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: iv dye, iodine containing attending: chief complaint: syncope major surgical or invasive procedure: 1. aortic valve replacement with size 23 st. regent mechanical valve. 2. mitral valve repair with size 26 annuloplasty band. history of present illness: 57 yo female w h/o known bicuspid aortic valve (x2yrs) presented to outside hospital following syncopal episode while walking to work. echo revealed critical aortic stenosis with ava0.7cm2. cardiac cath confirmed critical as and ruled out significant coronary disease. cardiac surgery evaluation was requested for avr. the patient states she has been more fatigued recently. she denies shortness of breath- but admittedly does not partake in a lot of physical activity. past medical history: bicuspid aortic valve with aortic stenosis s/p tah s/p left nephrectomy age 24 s/p cholecystectomy social history: race: hispanic last dental exam: years lives with: two children (17 & 22), divorced occupation: spanish teacher- 7th & 8th grades tobacco: denies etoh: denies family history: mother alive at 87. father passed away age with alzheimers. 20 siblings and 2 children a&w. physical exam: pulse: 80 resp: 18 o2 sat: 95%ra b/p right: left: 107/73 height: weight: 273lb general: nad, wgwn, obese female, pleasant skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 3/6 sem abdomen: obese, soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema- trace varicosities: none neuro: grossly intact x pulses: femoral right: 2+ left: 2+ dp right: 1+ left: 1+ pt : np left: np radial right: 1+ left: 1+ carotid bruit right: left: no bruits pertinent results: echo: prebypass: a left-to-right shunt across the interatrial septum is seen at rest. a small secundum atrial septal defect is present. 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 valve is bicuspid. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate to severe (3+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results on at 900am. post bypass: patient is av paced and receiving an infusion of phenylephrine. biventricular systolic function is unchanged. mechanical valve seen in the aortic position. the leaflets move well and the valve appears well seated. the paeak gradient across the aortic valve is 20 mm hg. the mitral regurgitation varies between 2 to 3 +. dr present to confirm the findings. surgeon made aware of findings. decided to go back on cpb to fix the mitral regurgitation. post second bypass there is a jet seen extending from the aortic root to the left atrium. dr present to confirm findings. surgeon made aware. on cpb to fix it. despite third bypass run the jet extending from the aortic root to the left atrium persists. dr made aware. dr consulted. to be left alone for now. annuloplasty ring seen in the mitral position. it appears well seated. trivial mitral regurgitation persists. aorta is intact post decannulation. 03:40am blood wbc-13.0* rbc-3.52* hgb-10.8* hct-32.2* mcv-92 mch-30.6 mchc-33.4 rdw-14.6 plt ct-416 03:40am blood glucose-113* urean-35* creat-1.1 na-138 k-4.3 cl-97 hco3-33* angap-12 03:40am blood calcium-9.9 phos-3.8 mg-2.1 04:18am blood pt-26.1* ptt-28.7 inr(pt)-2.5* 05:36am blood pt-25.1* inr(pt)-2.4* 05:32am blood pt-25.1* inr(pt)-2.4* 05:27am blood wbc-12.8* rbc-3.44* hgb-10.4* hct-31.4* mcv-91 mch-30.1 mchc-33.0 rdw-14.6 plt ct-395 05:27am blood glucose-113* urean-37* creat-1.2* na-137 k-3.8 cl-92* hco3-37* angap-12 05:27am blood pt-26.5* ptt-28.1 inr(pt)-2.6* brief hospital course: this 57-year-old patient with recent syncopal attacks was investigated and was found to have a critical aortic stenosis, moderate mitral regurgitation with preserved left ventricular function. the patient was brought to the operating room on where the patient underwent an aortic valve replacement with size 23 st. regent mechanical valve and mitral valve repair with size 26 annuloplasty band. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. the patient was diuresed on post operative day 1 and ventilator was weaned. early pod 2 found the patient extubated, alert and oriented and breathing comfortably. she was weaned off her vasoactive medications on post operative day 2, including epinephrine and neosynephrine. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. she went into a rapid atrial fibrillation and was loaded with amiodarone in the cvicu. the patient was transferred to the telemetry floor for further recovery. beta blockers were increased and diltiazem was added for better heart rate control. coumadin was started for atrial fibrillation and mechanical avr. she was therapeutic with her inr at the time of discharge with a goal inr 2.5-3.5. chest tubes and pacing wires were discontinued without complication. cipro was started for a klebsiella uti (sensitive to cipro). she was completing a 3 day course at the time of discharge and had a repeat urine culture prior to discharge which was pending. an echocardiogram was done on and results were pending at the time of this discharge summary. upon discharge zaroxyln was stopped and lasix was changed to 40 mg po bid due to slight rise in bun and creatinine. her fluid status should be monitored closely and lasix dosing is to be reevaluated in 2 weeks based on need for further diuresis. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 9 the patient was ambulating with assistance, she was tolerating a full oral diet, the wound was healing and pain was controlled with ultram. the patient was discharged to house rehab in in good condition with appropriate follow up appointment instructions and lab work instructions. medications on admission: aspirin 81mg daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 6. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 7. amiodarone 200 mg tablet sig: two (2) tablet po twice a day: 400 mg x 1 week then 400 mg daily x 2 weeks then 200 mg daily x 1 month then as directed by cardiologist. 8. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 9. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day): hold for sbp<100 hr<60. 10. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day): hold for sbp<100 hr<60. 11. warfarin 1 mg tablet sig: four (4) tablet po once (once): give 4 mg then dose for inr goal 2.5-3.5 for mech avr/a fib. 12. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 2 doses: last dose 2/18 am. 13. lasix 40 mg tablet sig: one (1) tablet po twice a day for 2 weeks: 40 mg x 1 week then 40 mg daily x 1 week. 14. potassium chloride 20 meq tablet, er particles/crystals sig: two (2) tablet, er particles/crystals po q12h (every 12 hours) for 2 weeks. discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: bicuspid aortic valve with aortic stenosis, mitral regurgitation s/p aortic valve replacement and mitral valve repair past medical history: s/p tah s/p left nephrectomy age 24 s/p cholecystectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage 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. on at 2:15pm cardiologist: dr. on at 3:45pm. please call to schedule appointments with your primary care: family practice (her pcp, . recently left practice) in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication a fib, mech avr give coumadin 4 mg on and check bun/crea/k/inr on goal inr 2.5-3.5 long term coumadin follow up to be arranged upon discharge from rehab md procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve open heart valvuloplasty of mitral valve without replacement other repair of heart and pericardium diagnoses: thrombocytopenia, unspecified anemia, unspecified urinary tract infection, site not specified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site atrial fibrillation other chronic pulmonary heart diseases nausea with vomiting hemorrhage complicating a procedure mitral valve insufficiency and aortic valve stenosis surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation accidents occurring in residential institution congenital insufficiency of aortic valve acquired absence of kidney persistent postoperative fistula 

Answer: The patient is high likely exposed to