Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The transvenous pacemaker remains in place . Electrodes appear intact . Bronchovascular markings remain prominent . The lungs are otherwise clear . There is no focal consolidation . There is no evidence of a pneumothorax . A large calcification consistent with a calcified granuloma is again noted on the right . The patient is status post aortic valvuloplasty as before . The heart is mildly enlarged . The aorta is calcified . Mediastinal structures are unchanged . Degenerative changes are again noted in the spine and shoulders .
    OUTPUT:
    
No active cardiopulmonary disease . No acute change . Dedicated bone images are recommended if further evaluation is clinically indicated .