Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy , CABG , and aortic valve replacement . The lungs are hyperinflated with flattening of the diaphragms suggestive of COPD . The heart remains mildly enlarged . Aortic knob is calcified . The mediastinal and hilar contours are unchanged , with mild pulmonary vascular congestion again noted . Small right pleural effusion is similar in size compared to the previous exam , with adjacent compressive atelectasis . No left - sided pleural effusion or pneumothorax is seen . There are no acute osseous abnormalities .
    OUTPUT:
    
Similar appearance of small right pleural effusion with adjacent right basilar atelectasis and mild pulmonary vascular congestion .