Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . The patient is status post median sternotomy and mitral valve replacement . There is a small - to - moderate left pleural effusion with overlying atelectasis . Fluid is also seen layering in the left major fissure , on the lateral view . Lung is clear . No pneumothorax is seen . The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged . There has been interval removal of a right - sided PICC .
    OUTPUT:
    
Small to moderate left pleural effusion with overlying atelectasis and fluid seen in the major fissure . Persistent enlargement of the cardiac silhouette .