Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal silhouette and hilar contours are unchanged with re demonstration of paramediastinal fibrosis from prior radiation therapy . Small bilateral pleural effusions are similar in volume compared to ___ . Again appreciated is mild central vascular fullness compatible with volume overload . There is no pneumothorax . Median sternotomy wires in are in place . The osseous structures are grossly unremarkable .
    OUTPUT:
    
Similar appearance to ___ with redemonstration of small bilateral pleural effusions , mild volume overload and paramediastinal fibrosis .