Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: New cardiac pacemaker in place tips right atrium , right ventricle . Status post TAVR . Left pleural effusion , similar . Left basilar consolidation , likely atelectasis , similar . No pneumothorax . Surgical clips right upper quadrant . Degenerative changes spine .
    OUTPUT:
    
New cardiac pacemaker .