Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Pleurex drain catheter tip projects over the left lower hemithorax . Moderate left pleural effusion persists and is probably slightly worse with increased rightward shift of the right heart border compared to the prior exam despite coexisting left atelectasis . Remaining aerated left lung is overall similar in appearance with perhaps slightly improved aeration of the left lung apex . The right lower lung is grossly clear . The heart is severely enlarged . Calcification of the aortic knob unchanged . No pneumothorax .
    OUTPUT:
    
Persistent and slightly worse moderate - to - large left pleural effusion despite Pleurex placement .