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: history of present illness: this is an 83 year old white female patient admitted to on with a recent increase of shortness of breath. she was found to be in congestive heart failure at that time and treated with intravenous lasix. a subsequent echocardiogram revealed wide open mitral regurgitation by report as well as critical aortic stenosis. she was transferred to the where she underwent cardiac catheterization. this revealed two vessel coronary artery disease as well as critical aortic stenosis with an aortic valve area of 0.4 and a peak gradient of 60 and 2 to 3+ mitral regurgitation. she was referred for coronary artery bypass graft and aortic valve replacement and mitral valve replacement. past medical history: paroxysmal atrial fibrillation, chronically on coumadin, mild dementia, hypertension, paget's disease status post right femoral fracture with open reduction and internal fixation many years ago, she has an ischemic left optic nerve and she has osteoporosis. allergies: the patient states an allergy to ciprofloxacin although she does not know the reaction. she is married and lives with her husband and she has never smoked cigarettes and denies alcohol intake. medications prior admission: atenolol 50 mg p.o. q.d., coumadin 5 mg p.o. q.d., fosamax 70 mg q. week, aricept 5 mg q.d., hydrochlorothiazide 25 mg q.d., spironolactone 25 mg q.d., calcium and vitamin e. physical examination: preoperative physical examination was unremarkable with the exception of an irregular heart rhythm and a grade iv/vi systolic murmur. laboratory data: preoperative carotid studies were obtained and revealed less than 40% occlusion, bilateral and her preoperative laboratory values were unremarkable. hospital course: preoperatively neurologic evaluation was requested due to memory dysfunction and dementia. the neurologist recommendation was to continue the aricept and they also commented that there was no contraindication to surgery. this was felt to be a mild dementia with some components of delirium. on , the patient was taken to the operating room with dr. where she underwent coronary artery bypass graft times one with a saphenous vein to the posterior descending artery as well as an aortic valve replacement with a #19 mm - magna pericardial valve and she had a mitral valve repair at that time as well. postoperatively the patient was ventricularly paced via her epicardial wires. she was on levophed, milrinone and propofol intravenous drip and was transported from the operating room to the cardiac surgery recovery unit in stable condition. on postoperative day #1, the patient remains on levophed, milrinone drips as well as amiodarone, was atrially paced at that time. attempts were made to wean from the ventilator, however, because of a decreased level of wakefulness it was felt best to hold off at that time. neurology follow up recommended a repeat head imaging. the patient did go for a computerized tomography scan which was negative for any acute infarction. the patient was ultimately extubated the afternoon of postoperative day #2. her mental status was clearing. she was much more awake at that time and was moving all four extremities. the patient did subsequently return to atrial fibrillation and her temporary pacing was discontinued as a result of that. she was begun on heparin drip on postoperative day #4 due to continued atrial fibrillation with rate in the 90s and blood pressure of 130/50. she had been oxygenating well on 2 liters of nasal cannula and making slow but steady progress with her level of consciousness and physical therapy level. on postoperative day #5, the patient was begun on oral lopressor, diuresis was initiated and she had been started on coumadin on postoperative day #4 and this was continued as well through postoperative day #5. the patient was transferred from the cardiac surgery recovery unit to the telemetry floor on , postoperative day #5. she was in good condition. she was beginning to ambulate with physical therapy, however, it was felt in her best interest at that time to discharge her from the hospital to a rehabilitation facility since she is still not quite steady on her feet requiring a fair amount of assistance with physical therapy. she has remained hemodynamically stable in atrial fibrillation with a rate of about 100 and a blood pressure of 110/50. the patient remains on a heparin drip at 900/hr with a ptt of 54.3 today and her coumadin has been 5 mg/day for the past three days, those would be , and . her most recent inr from today, , is 1.3 and she will receive 5 mg this evening as previously stated. she should remain on her heparin drip until her inr is above 1.8. at that point her heparin may be discontinued and she may be maintained on coumadin with a target inr of 2 to 2.5. preoperatively the patient was on 5 mg/day as her routine daily dose. on physical examination the patient is awake and communicating appropriately, although occasionally forgetful as to time and place, but otherwise responds appropriately to commands and questions. her lungs are diminished in the bilateral bases, otherwise clear. her heart is irregularly irregular with no murmurs noted. her abdomen is soft and her incisions are clean, dry and intact. medications on discharge: 1. lopressor 25 mg p.o. b.i.d. 2. lasix 20 mg p.o. q. 12 hours times ten more days. 3. potassium chloride 20 meq p.o. q. 12 hours, also times ten days. 4. colace 100 mg p.o. b.i.d. 5. ranitidine 75 mg p.o. b.i.d. 6. aspirin 325 mg p.o. q.d. 7. enteric coated aspirin 81 mg p.o. q.d. 8. aricept 5 mg p.o. q.h.s. 9. coumadin 5 mg p.o. q.d. to be titrated on a daily basis dependent upon her inr over the next few days and heparin drip at 900 units/hr and it is to be titrated according to her ptt and discontinued when her inr is greater than 1.8. discharge condition: good. discharge diagnosis: 1. aortic stenosis. 2. mitral regurgitation. 3. coronary artery disease, status post aortic valve replacement. 4. mitral valve repair. 5. coronary artery bypass graft times one. follow up: the patient should follow up with dr. approximately six weeks postoperatively. she should also follow up with her primary care physician as well as her cardiologist upon discharge from the rehabilitation facility. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters insertion of endotracheal tube (aorto)coronary bypass of one coronary artery arterial catheterization open and other replacement of aortic valve with tissue graft combined right and left heart angiocardiography pulmonary artery wedge monitoring transfusion of packed cells open heart valvuloplasty of mitral valve without replacement transfusion of other serum diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension atrial fibrillation other persistent mental disorders due to conditions classified elsewhere rheumatic heart failure (congestive) mitral valve insufficiency and aortic valve stenosis osteitis deformans without mention of bone tumor 

Answer: The patient is high likely exposed to