Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette remains enlarged , similar to the prior examination . Coronary artery calcifications , postsurgical changes after valve replacement , and aortic arch calcifications are again seen . There no focal pulmonary opacities , pleural effusions , or evidence of pneumothorax . Osseous structures are unremarkable .
    OUTPUT:
    
Stable cardiomegaly . No evidence of acute cardiopulmonary process .