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: aspirin attending: chief complaint: shortness of breath major surgical or invasive procedure: coronary artery bypass graft x 3 (lima to lad, svg to om, svg to rca), mitral valve replacement (27mm pericardial tissue valve), valve replacement (23mm pericaridial tissue valve), ascending aorta replacement (28m gelweave graft) mediastinal exploration with evacuation of clot history of present illness: 79 y/o female who developed a respiratory infection in which was treated with antibiotics. she then underwent a ct scan which showed an enlarged ascending aorta. echo revealed a dilated ascending aorta, insufficiency, and mitral regurgitaion. cath also revealed these results along with three vessel coronary artery disease. she was referred for surgical intervention. past medical history: hyperlipidemia, hypertension, gastroesophageal refulx disease, renal insufficiency, hypothyroidism, degenerative joint disease, anxiety/depression, detached left retina, h/o colon perforation with colonoscopy, s/p r ear stapedectomy social history: artist. denies tobacco. rare wine. family history: mother with rhd. physical exam: vs: 74 sr 132/40 61" 143# general: 79 y/o wdwn female in nad skin: w/d -lesions heent: ncat, perrl, anicteric sclera, op benign neck: supple, from, -jvd, ?bruit vs. transmitted murmur chest: ctab -w/r/r heart: rrr, 3/6 systolic murmur abd: soft, nt/nd +bs ext: warm, well-perfused, -edema, ble varicosities r>l. lipoma rle neuro: a&o x 3, mae, non-focal, strength 5/5 pertinent results: echo : prebypass: the left atrium is moderately dilated. overall left ventricular systolic function is normal (lvef>55%). the ascending aorta is markedly dilated at 5.3 cm. the sinotubular junction is 3.5cm. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. moderate to severe (3+) regurgitation is seen. there is partial posterior mitral leaflet flail. with a torn mitral chordae are present. moderate (2+) mitral regurgitation is seen. the mitral regurgitation jet is eccentric and directed toward the anterior mitral valve leaflet. postbypass: there is a well seated well functioning biprosthesis in the position. there is trace valvular ai. there is a well seated well functioning bioprosthesis in the mitral position. there is trace valvular mr. tube graft is visualized in the proximal ascending aorta. echo : icu/ preop: overall left ventricular systolic function is normal (lvef>55%). the left heart appears underfilled. there is a collection of fluid measuring 1.6-1.7 cm in greatest diameter both anterior to and posterior to the heart. there is some stranding in these collections, suggesting early organization. there are large bilateral pleural effusions, right greater than left. post evacation: the pericardial fluid collections are now absent. pleural effusions are now small to trivial in size. biventricular function is preserved with lvef >55%. head ct : 1. no evidence of intracranial hemorrhage. 2. no large acute major vascular territorial infarct. if there is further clinical concern, an mri would be more sensitive in evaluating for ischemic injury. 3. status post intubation. vascular calcifications are noted within the vertebral arteries and carotid siphons bilaterally. cxr : 1. stable moderate-sized left pleural effusion and left lower lobe atelectasis. 2. decreased size of small right pleural effusion with minimal residual right lower lobe atelectasis. 04:53pm blood wbc-11.7* rbc-2.81*# hgb-6.9*# hct-20.1*# mcv-72* mch-24.4* mchc-34.1 rdw-18.2* plt ct-140* 05:23pm blood wbc-8.6 rbc-3.67* hgb-10.8* hct-30.3* mcv-83 mch-29.4 mchc-35.6* rdw-16.5* plt ct-154# 03:02am blood wbc-12.3* rbc-3.60* hgb-10.6* hct-30.0* mcv-83 mch-29.4 mchc-35.4* rdw-17.1* plt ct-131* 05:40am blood wbc-12.4* hct-37.3 04:53pm blood pt-19.7* ptt-48.2* inr(pt)-1.9* 05:40am blood pt-21.9* ptt-38.0* inr(pt)-2.1* 06:56pm blood urean-32* creat-1.1 cl-109* hco3-23 05:40am blood glucose-79 urean-30* creat-1.4* na-132* k-4.3 cl-92* hco3-30 angap-14 05:45am blood calcium-8.8 phos-3.7 mg-2.2 10:00am urine rbc-11* wbc-3 bacteri-mod yeast-none epi-<1 brief hospital course: ms. was a same day admit and underwent all pre-op work-up as an outpatient. on she was brought to the operating room where she underwent an coronary artery bypass graft x 3, mitral valve replacement, valve replacement, and ascending aorta replacement. please see operative report for surgical details. she was transferred to the csru for invasive monitoring in stable condition. post-operatively she required volume resuscitation and received ffp, prbc's, and protamine. on post-op day one she was on multiple pressors/inotropes and underwent a bronchoscopy to evaluate lll opacity. also on this day she underwent an echo for hemodynamic instability which ultimately required a re-operation for mediastinal exploration and clot evacuation. on post-op day two she had an episode of atrial fibrillation and she was given lopressor and started on amiodarone. her neurological status was also examined (with weaning sedation) and she had poor movement in her left upper extremity. she underwent a head ct which was negative for a cva. on post-op day three she underwent a bronchoscopy for a therapeutic aspiration of secretions. she continued to be in atrial fibrillation and electrical cardioversion was attempted with conversion to slow sinus. cardiology (ep) was consulted for further management of arrhythmias. by post-op day four she converted back to afib and heparin gtt was started. she was ultimately started on coumadin and heparin was stopped once her inr was therapeutic. for the rest of her hospital course she converted in and out of afib. she continued to remain intubated and again underwent therapeutic aspiration via bronchoscopy. there continued to be a persistent left basilar atelectasis with left pleural effusion. her chest tubes were removed and she was finally weaned off sedation on post-op day six, appeared neurologically intact and was extubated. on post-op day seven she underwent a speech and swallow study and her diet was advanced as tolerated. she had aggressive pulmonary toilet with is, inh/mdi's and diuretics for her pleural effusions. on post-op day eleven she had a +ua and was started on antibiotics. she remained in the csru until post-op day twelve d/t the extended intubation, post-op afib, poss. cva and her desaturating following extubation. as mentioned she was transferred to the telemetry cardiac floor on post-op day twelve. she continued to have pleural effusions and atelectasis despite aggressive pulmonary toilet. physical therapy followed patient during entire post-op course. she appeared to be stable and physical therapy recommended rehab placement d/t decreased endurance and mobility. on post-op day fourteen she was discharged to rehab facility in stable condition and will f/u with appropriate appointments. medications on admission: diovan 160/25mg qd, synthroid 88mcg qd, triamteren/hctz 37.5/25mg qd, toprol xl 25mg qd, cymbalta 60mg qd, prevacid, immodium, benefiber discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours). 3. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 6. diltiazem hcl 90 mg tablet sig: one (1) tablet po qid (4 times a day). 7. duloxetine 30 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 8. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 9. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. 10. levothyroxine 88 mcg tablet sig: one (1) tablet po daily (daily). 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 12. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 13. warfarin 1 mg tablet sig: three (3) tablet po daily (daily): 3 mg for 2 days, then check inr and dose coumadin. 14. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily): 400 mg daily x 6 days then 200 mg daily. 15. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). discharge disposition: extended care facility: house of discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 3 mitral regurgitation s/p mitral valve replacement insuffiency s/p valve replacement ascending aneurysm s/p ascending aorta replacement post-operative atrial fibrillation pmh: hyperlipidemia, hypertension, gastroesophageal refulx disease, renal insufficiency, hypothyroidism, degenerative joint disease, anxiety/depression, detached left retina, h/o colon perforation with colonoscopy, s/p r ear stapedectomy 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 heavy lifting or driving. followup instructions: provider: , follow-up appointment should be in 1 month provider: , follow-up appointment should be in 2 weeks dr. 2 weeks procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnostic ultrasound of heart diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances other electric countershock of heart other intubation of respiratory tract reopening of recent thoracotomy site open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus open and other replacement of mitral valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension unspecified acquired hypothyroidism thoracic aneurysm without mention of rupture atrial fibrillation mitral valve insufficiency and aortic valve insufficiency chronic kidney disease, unspecified pulmonary collapse hemorrhage complicating a procedure other and unspecified coagulation defects 

Answer: The patient is high likely exposed to