Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Transvenous right atrial biventricular pacer defibrillator leads follow standard placements . Patient has had aortic and mitral valve replacements . Lungs are clear . Heart size normal . No pneumothorax or effusion .
    OUTPUT:
    
Transvenous right atrial biventricular pacer defibrillator leads follow standard placements