Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and aortic , mitral , and tricuspid valve replacement . Severe cardiomegaly is re - demonstrated . Prominence of the pulmonary artery again raises concern for underlying pulmonary arterial hypertension . Mediastinal contour is unchanged . There is mild pulmonary vascular congestion , improved from the previous chest radiograph , likely chronic . No overt pulmonary edema is seen . No focal consolidation , pleural effusion or pneumothorax is present . Compression deformities involving T7 , T12 , and L1 are better assessed on the recent thoracic spine radiograph .
    OUTPUT:
    
Unchanged severe cardiomegaly with mild pulmonary vascular congestion without overt pulmonary edema . Known compression deformities involving the thoracolumbar spine are better assessed on the previous thoracic spine radiograph .