Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A portable frontal chest radiograph again demonstrates intact sternal wires , an enteric tube extending below the diaphragm and off the inferior edge of the image , right PICC terminating in the low SVC , left chest wall pacer device with a single lead projecting over the right ventricle , and left ventricular assist device , unchanged in position . There has been interval removal of a left chest pigtail catheter . Heart size remains markedly enlarged . There is no new focal consolidation . A small left pleural effusion is not significantly changed . There is no right pleural effusion . No pulmonary edema or pneumothorax is present .
    OUTPUT:
    
No significant change in a small left pleural effusion after removal of a left chest pigtail catheter .