Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy , aortic arch stent graft repair , and aortic valve replacement with multiple clips noted projecting over the right axillary region . Severe cardiomegaly is again noted with diffusely dilated thoracic aortic contour compatible with known dissection and subsequent aortic graft repair . Overall , the cardiac and mediastinal contours are unchanged . There is mild pulmonary vascular congestion , worse in the interval . Retrocardiac opacity appears unchanged compatible with atelectasis with similar - appearing small left pleural effusion . There has been interval improvement in the right basilar patchy opacity compatible with improving atelectasis , with decreased size of the right pleural effusion which is partially loculated in the fissure . No pneumothorax is detected . No acute osseous abnormalities seen .
    OUTPUT:
    
Unchanged appearance of the cardiac and mediastinal contours compatible with known aortic dissection status post aortic arch graft placement . Mild pulmonary vascular congestion , slightly worse in the interval . Unchanged left basilar opacity compatible with atelectasis and small left pleural effusion . Interval decrease in size of small right pleural effusion with improved aeration in the right lung base .