Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Bilateral moderate size pleural effusions are increased with increased interstitial markings and vascular congestion compatible with moderate to severe pulmonary edema . Mid and lower lung right greater than left pulmonary opacities , may reflect atelectasis in this setting of effusions and pulmonary edema , however a in multifocal infectious process or aspiration can not be excluded . Moderate cardiomegaly persists unchanged . Patient is status post median sternotomy and cardiac valve replacement .
    OUTPUT:
    
Moderate to severe congestive failure with bilateral moderate - sized pleural effusions , increased . As these findings could mask an underlying infectious process , if clinical concern persists repeat imaging after diuresis is recommended .