Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post aortic valve replacement and probably coronary artery bypass graft surgery . A dual - lead pacemaker / ICD device appears unchanged . The heart is moderately enlarged . The mediastinal and hilar contours appear unchanged . There is no pleural effusion or pneumothorax . The lungs appear clear . The bones are probably demineralized . Mild degenerative changes along the lower thoracic spine appear similar .
    OUTPUT:
    
No evidence of acute disease .