Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is re - demonstrated with leads in unchanged positions . Patient is status post TAVR , in unchanged position . Moderate enlargement of the cardiac silhouette is similar to the prior study . The aorta is diffusely calcified and mildly tortuous . There is mild pulmonary vascular congestion , improved compared to the previous examination . There are tiny bilateral pleural effusions which are decreased in size compared to the prior study . No focal consolidation or pneumothorax is present . There are mild multilevel degenerative changes seen in the thoracic spine .
    OUTPUT:
    
Mild pulmonary vascular congestion and tiny bilateral pleural effusions , improved compared to the previous examination .