Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest again demonstrate intact median sternotomy wires with surgical clips overlying the left heart border . The moderate - sized left pleural effusion with adjacent atelectasis is unchanged since the prior radiograph . The remainder of the left lung parenchyma as well as the right lung is clear . The cardiac contour is obscured by the pleural effusion and unchanged since the prior radiograph . No pneumothorax is appreciated .
    OUTPUT:
    
Unchanged appearance of moderate - sized left pleural effusion with adjacent atelectasis .