Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe cardiomegaly is a stable . Moderate to large bilateral pleural effusions are larger on the left probably unchanged from prior study . Left mid atelectasis is unchanged . Vascular congestion has improved . There is no evident pneumothorax . Sternal wires are aligned . Patient is status post AVR . Pacer leads are in standard position with tips in the right atrium and right ventricle . Right PICC tip is in the cavoatrial junction
    OUTPUT:
    
Pacer leads in standard position . No pneumothorax . Improved vascular congestion