Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy with mitral and tricuspid valve replacements . Moderate to severe cardiomegaly is re - demonstrated , unchanged . Mediastinal and hilar contours are similar with marked mediastinal lymphadenopathy again noted . There has been interval removal of the previously noted left subclavian central venous catheter . Moderate to large loculated right pleural effusion remains unchanged with continued right basilar opacification . Left lung is clear . No pulmonary edema or pneumothorax is seen . No acute osseous abnormality is detected .
    OUTPUT:
    
No substantial interval change in appearance of moderate to large loculated right pleural effusion and right basilar opacification .