Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette is markedly enlarged , not changed since the prior examination . Aortic and mitral valve replacements are noted . The pulmonary vasculature is unremarkable . No definite consolidation is noted . Again noted is indistinctness of the right costophrenic angle . Median sternotomy wires are intact and well aligned . The visualized bones show no significant abnormalities .
    OUTPUT:
    
Stable examination of the chest without acute intrathoracic process .