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: lisinopril attending: chief complaint: exertional fatigue major surgical or invasive procedure: bentall procedure with a 29-mm freestyle graft with coronary button reimplantation, serial number . ascending aorta and hemi arch replacement with a 28 mm vascutek dacron tube graft using deep hypothermic circulatory arrest. full left-sided and right-sided maze procedure using the atricure synergy bipolar rf device with a combination of the cryocath. patent foramen ovale closure. history of present illness: 67-year-old woman has been followed for many years for a bicuspid aortic valve and ascending aortic aneurysm. in , she was referred for echocardiogram. at the time, she was noted to be in new atrial fibrillation. coumadin was not initiated d/t her aneurysm. she has been maintained on full strength aspirin. echo from showed trace to mild aortic insufficiency with an aortic diameter of 4.6cm. ct on has revealed that her ascending aorta is approaching 5cm. she has since undergone consultation with dr. and was referred for cardiac catheterization to further evaluate. she was found to have no coronary disease. past medical history: bicsupid aortic valve, aortic insufficiency ascending aortic aneurysm history of right breast ca( /chemo/xrt) r renal cell cancer atrial fibrillation, new onset in pelvic relaxation ( pessary in place) osteoarthritis hands and l foot depuytren's contracture carotid bruit l frozen shoulder colon polyp + ppd ()( mother had tuberculosis and died when pt was 2) gastric ulcer diverticulosis r mastectomy with implant r partial nephrectomy appendectomy social history: ms. lives with her daughter. she was a physical therapist at the department of public health. she denies any history of smoking or drinking alcohol. family history: she reports having a brother who underwent a coronary artery bypass grafting at age 55. physical exam: pulse: 80 resp: 18 o2 sat: 97/ra b/p right: no bp (mast.) left: 117/59 height: 63" weight: 172 lbs general: no acute distress well nourished skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema none varicosities: none neuro: alert and oriented x3 nonfocal pulses: dp right: doppler left: doppler pt : doppler left: doppler radial right: +1 left: +1 carotid bruit right and left transmitted murmur vs bruit pertinent results: echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - ejection fraction: 50% to 55% >= 55% aorta - annulus: 2.9 cm <= 3.0 cm aorta - sinus level: *4.5 cm <= 3.6 cm aorta - sinotubular ridge: *4.3 cm <= 3.0 cm aorta - ascending: *4.9 cm <= 3.4 cm aortic valve - peak velocity: 1.0 m/sec <= 2.0 m/sec aortic valve - peak gradient: 7 mm hg < 20 mm hg findings left atrium: depressed laa emptying velocity (<0.2m/s) probable thrombus in the laa. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. bidirectional shunt across the interatrial septum at rest. small secundum asd. left ventricle: normal lv wall thickness. normal regional lv systolic function. low normal lvef. right ventricle: normal rv chamber size and free wall motion. aorta: moderately dilated aorta at sinus level. moderately dilated ascending aorta aortic valve: bicuspid aortic valve. moderately thickened aortic valve leaflets. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: mild tr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. the rhythm appears to be atrial fibrillation. results were personally reviewed with the md caring for the patient. conclusions prebypass the left atrial appendage emptying velocity is depressed (<0.2m/s). a probable thrombus is seen in the left atrial appendage. there is a bidirectional shunt across the interatrial septum at rest. a small secundum atrial septal defect is present. left ventricular wall thicknesses are normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size and free wall motion are normal. the aortic root is moderately dilated at the sinus level. the ascending aorta is moderately dilated. the aortic valve is bicuspid. the aortic valve leaflets are moderately thickened. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. dr. was notified in person of the results on at 845 am post bypass patient is in sinus rhythm and receiving an infusion of phenylephrine and epinephrine. rv function is moderately depressed which improved somewhat with epinephrine. lvef= 40%. the inferior wall appears significantly depressed. there is a bioprosthetic valve seen in the aortic position. the valve appears well seated and the leaflets move well. there is no aortic insufficiency. there is 2+ mitral regurgitation. the left atrial appendage has been ligated. no flow detected across the inter atrial septum. brief hospital course: ms. was admitted same day surgery and was brought to the operating room for bental, hemiarch replacement, maze, left atrial appendage, and patent foramen ovale closure. see operative report for further details. she received cefazolin for perioperative antibiotics and was transferred to the intensive care unit for post operative management. she required epinephrine and neosynephrine for hemodynamic support. she remained intubated overnight for hemodynamic management and weaned off epinephrine post operative day one. she was weaned from sedation, awoke neurologically intact, and was extubated on post operative day one. she remained in the intensive care unit for rhythm monitoring requiring epicardial pacing for junctional rhythm and phenylephrine for blood pressure management. physical therapy worked with her on strength and mobility. by post-operative day 11 she was ready for discharge to rehab. all follow-up appointments were advised. medications on admission: atenolol 100 mg each am and 50 mg each pm irbesartan 37.5 mg daily simvastatin 10 mg daily aspirin 325 mg daily calcium carbonate-vitamin d3 600 mg (1,500 mg)-400 unit tablet daily cyanocobalamin daily ibuprofen 200 mg prn multivitamin-ca-iron-minerals daily omega-3 fatty acids 1,000 mg daily discharge medications: 1. amiodarone 200 mg tablet sig: two (2) tablet po twice a day: 200mg two times daily for three weeks, then decrease to 200mg daily ongoing. disp:*120 tablet(s)* refills:*2* 2. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. disp:*20 tablet(s)* refills:*2* 3. potassium chloride 10 meq tablet extended release sig: four (4) tablet extended release po q12h (every 12 hours) for 10 days. disp:*80 tablet extended release(s)* refills:*2* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 6. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. omega-3 fatty acids capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 8. cyanocobalamin (vitamin b-12) 100 mcg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 10. metoprolol tartrate 50 mg tablet sig: one (1) tablet po q6h (every 6 hours). disp:*120 tablet(s)* refills:*2* 11. coumadin 1 mg tablet sig: one (1) tablet po once for 1 doses: goal inr for atrial fibrillation. inr to be followed by the clinic at . disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: health vna discharge diagnosis: ascending aortic aneurysm bicsupid aortic valve aortic insufficiency atrial fibrillation right breast cancer renal cell cancer pelvic relaxation osteoarthritis hands and l foot depuytren's contracture carotid bruit left frozen shoulder colon polyp + ppd gastric ulcer diverticulosis discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage edema 1+ 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 1:00pm cardiologist: dr on at 1:30pm in wound check: wed at 10:45 at please call to schedule appointments with your primary care dr in weeks , np in atrius cardiology in 2 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 atrial fibrillation goal inr 2.0-3 first draw results to phone fax the clinic at . attention: phone procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels other and unspecified repair of atrial septal defect excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: unspecified essential hypertension thoracic aneurysm without mention of rupture atrial fibrillation aortic valve disorders personal history of malignant neoplasm of breast ostium secundum type atrial septal defect congenital insufficiency of aortic valve personal history of malignant neoplasm of kidney other ill-defined heart diseases 

Answer: The patient is high likely exposed to