Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Tracheostomy , atrioventricular pacemaker and right - sided PICC line are in unchanged position and adequate . Moderate pulmonary edema has slightly worsened since previous exam . Patient has prior sternotomy for AVR and MVR and moderate cardiomegaly . Bilateral moderate layering pleural effusions are stable . There is no pneumothorax .
    OUTPUT:
    
1 . Tube and lines are in adequate position . 2 . Moderate pulmonary edema has worsened . 3 . Unchanged bilateral moderate layering pleural effusion .