Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy . Surgical clips project along the mediastinum and the right axillary region . The heart is mildly enlarged as before . The aorta is tortuous compared to the prior radiographs but similar to the appearance previously depicted on the scout view of the prior CT . Left - sided rib deformities are probably also unchanged . There is slight blunting of the left costophrenic sulcus , potentially a trace pleural effusion . There is persistent mild elevation of the right hemidiaphgram . The lungs appear clear . Small osteophytes are similar along the mid thoracic spine .
    OUTPUT:
    
Status post sternotomy with post-surgical changes . Suspected trace left - sided pleural effusion .