Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and aortic valve replacement . Right - sided pacemaker / AICD device is again noted with leads terminating in the right atrium , right ventricle , and the region of the coronary sinus , unchanged . Enlargement of the cardiac silhouette is moderate , and similar compared to the previous study . The mediastinal and hilar contours are normal . There continues to be upper zone vascular redistribution , similar when compared to the previous study compatible with mild pulmonary vascular engorgement . Lungs remain hyperinflated compatible with COPD . Linear opacities in the lung bases are compatible with scarring . Small bilateral pleural effusions are relatively unchanged . There is no pneumothorax .
    OUTPUT:
    
Mild pulmonary vascular congestion , similar compared to the previous study with small bilateral pleural effusions . Scarring within the lung bases .