Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is persistent increased interstitial markings similar prior . There is no confluent consolidation . Trace bilateral pleural effusions are seen . There is moderate cardiomegaly and a hiatal hernia . Aortic valve replacement is again noted . No acute osseous abnormalities identified .
    OUTPUT:
    
Findings suggesting pulmonary vascular congestion and trace bilateral effusions . No confluent consolidation .