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: mrs. is a 46-year-old woman with a history of congestive heart failure, mitral valve repair, complete heart block and asthma who was admitted to the hospital for heparinization prior to a planned redo mitral valve replacement with dr. . the patient originally had a mechanical valve placed about 10 years ago, she developed complete heart block and had a pacemaker placed after the mitral valve surgery. while she was having her pacemaker replaced in , she developed a mitral valve thrombus, followed by a successful thrombolysis, however, a tee (transesophageal echocardiogram) done at that time, revealed the mitral valve failure, and she was scheduled for surgery. mrs. says her goal inr since then has been 3 to 4. she was recently admitted for surgery but it was delayed because she had an inr that was greater than 5. she was discharged with daily inr checks and told to return to mc when her inr was less than 3.5. on the day of admission, her inr is 2 and she comes to mc for heparinization prior to her catheterization and mitral valve surgery. past medical history: congestive heart failure, complete heart block, depression, allergic rhinitis, asthma, anxiety and status post mitral valve replacement. social history: remote tobacco use. denies alcohol use. family history: cad (coronary artery disease), her father had a cabg (coronary artery bypass graft) in his early 60s. physical exam: temperature 98.4, blood pressure 120/80, respiratory rate 20, o2 sat 96 percent on room air. general: anxious young woman in no acute distress. heent: pupils equally round and reactive to light. extraocular movements intact. sclera anicteric. oropharynx pink. neck: supple with no lymphadenopathy. lungs: clear to auscultation bilaterally. cardiac: regular rate rhythm with a late systolic ejection murmur. abdomen: soft, nontender, nondistended with normal active bowel sounds. no hepatosplenomegaly. extremities: with no clubbing, cyanosis or edema. neuro: alert and oriented x4, responds appropriately, follows commands. cranial nerves intact. strength was throughout. sensation to light touch is intact throughout. laboratory data: pt is 18.4, inr is 2.1. tee on : prostatic mitral valve leaflet is normal with only one disk appearing to open. the gradients are higher than expected for this type of prosthesis. medications on admission: zoloft 100 mg q. nightly. the patient states no known drug allergies. the patient went for cardiac catheterization on that showed moderate to severe mitral stenosis with no pulmonary hypertension, 1+ mr (mitral regurgitation) an ef (ejection fraction) of 50 percent, and no angiographically apparent cad (coronary artery disease)> the patient was followed by the medicine service over the next several days while awaiting for her inr to come down and on , she was brought to the operating room where she underwent mitral valve replacement. please see the or report for full details. in summary, the patient had a mitral valve replacement with a no. 27 st. jude valve. her bypass time was 117 minutes with a crossclamp time of 84 minutes. she tolerated the operation well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient was sent a-sensed and v-paced at a rate of 96 beats per minute with a mean arterial pressure of 74 and a cvp of 4 with epinephrine at 0.03 mics/kilogram/minute, neo-synephrine at 0.5 mics/kilogram/ minute and propofol at 10 mics/kilogram/minute. the patient did well in the immediate postoperative period, her anesthesia was reversed. she was weaned from the ventilator and successfully extubated on postoperative day 1. the patient remained hemodynamically stable, although she was noted to have periods of ventricular bigeminy, and the electrophysiology service was consulted at that time. she continued on an amiodarone drip, as well as a neo-synephrine drip and she was kept in the intensive care unit for hemodynamic monitoring. by postoperative day 2, the patient had weaned off her neo-synephrine drip. she was transitioned to oral amiodarone. her chest tubes, as well as temporary pacing wires, were removed. she was begun on heparin, as well as warfarin, and transferred to the floor for continuing postoperative care and cardiac rehabilitation. once on the floor, the patient had an uneventful postoperative course. her activity level was increased with the assistance of the nursing staff as well as the physical therapy staff. her warfarin doses were adjusted to attain a goal inr of 3 to 3.5, and ultimately on postoperative day 5, it was decided that the patient would be stable and ready to be discharged home. at the time of this dictation, the patient's physical exam is as follows: temperature 98.9, heart rate 80 a-sensed, v- paced, blood pressure 108/60, respiratory rate 16, o2 sat 95 percent on room air. weight on day of discharge 54.5, preoperatively 53. laboratory data: white count 12.4, hematocrit 34, platelets 547, sodium 141, potassium 4.0, chloride 99, co2 29, bun 17, creatinine 1.2, glucose 96, pt 22.8, ptt 38, inr 3.3. physical exam: neuro: alert and oriented x3. moves all extremities. follows commands. nonfocal exam. pulmonary: clear to auscultation bilaterally. cardiac: regular rate and rhythm, s1-s2 with a sharp click. sternum is stable. incision with steri-strips, open to air, clean and dry. abdomen: soft, nontender, nondistended with normal active bowel sounds. extremities: warm with trace edema. condition at discharge: good. discharge diagnoses: 1. status post redo mitral valve replacement with a no. 27 st. mechanical valve. 2. complete heart block, status post permanent pacemaker placement. 3. depression. 4. asthma. discharge medications: include potassium chloride 20 meq q.daily x2 weeks, oxycodone 5/325 1-2 tablets po q.4-6 hours p.r.n., sertraline 100 mg q.daily, albuterol 1-2 puffs q.6 hours p.r.n., warfarin as directed to maintain a goal inr of 3 to 3.5. the patient is to take 4 mg on and , then have an inr check on . further dosages to be prescribed by further dosage is to be prescribed by dr. . amiodarone 400 mg t.i.d. x1 week, then 400 mg b.i.d., x1 week, then 400 mg q.daily x1 week, and ultimately 200 mg q.daily. the patient is to take lasix 20 mg q.daily x2 weeks. she is to be discharged to home with visiting nurses. she is to have an inr check on monday the 15th, with results called to dr. . she is to have follow-up in the wound clinic in 2 weeks. follow-up with dr. in weeks. follow- up with dr. in 4 weeks. follow-up in the device clinic on at 10:30 a.m. and then follow-up with dr. in 1 month. , m.d. procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures diagnostic ultrasound of heart open and other replacement of mitral valve diagnoses: congestive heart failure, unspecified other complications due to heart valve prosthesis depressive disorder, not elsewhere classified cardiac pacemaker in situ mitral stenosis 

Answer: The patient is high likely exposed to