Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and mitral valve replacement . A left - sided defibrillator / pacemaker is noted and unchanged . The cardiac silhouette is enlarged . There is no large pleural effusion or pneumothorax . No definite evidence of edema .
    OUTPUT:
    
No acute intrathoracic abnormality .