Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is pulmonary vascular congestion without overt edema . Small bilateral pleural effusions are new since prior exam . There is moderate cardiomegaly . As seen on prior , there is radiopaque density over the region of the mitral valve compatible with patient 's known ___ clip . Coronary artery calcifications are again noted .
    OUTPUT:
    
Pulmonary vascular congestion with new small bilateral pleural effusions since last month 's exam .