Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and aortic valve replacement . Left - sided pacemaker device is noted with leads terminating in the right atrium and right ventricle . Severe cardiomegaly is similar compared to the prior study . The aorta remains tortuous and diffusely calcified . There is mild pulmonary vascular congestion with small bilateral pleural effusions , the latter of which appears increased from the prior study . Right upper lobe calcified granuloma is similar . Patchy opacities are seen in the lung bases . No pneumothorax is present . Diffuse demineralization of the osseous structures with multiple compression fractures at the thoracolumbar junction appears unchanged .
    OUTPUT:
    
Mild pulmonary vascular congestion and increased size of small bilateral pleural effusions . Patchy opacities in the lung bases may reflect atelectasis however infection can not be completely excluded .