Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate to severe cardiomegaly is unchanged , and an aortic valve replacement is in unchanged position . There has been interval removal of a right IJ temporary pacer line . There is no pneumothorax . There may be a small right pleural effusion , there is no left pleural effusion . There is no pulmonary edema or focal consolidation .
    OUTPUT:
    
1 . Unchanged moderate to severe cardiomegaly . 2 . Possible small right pleural effusion , no left pleural effusion .