Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and transcatheter aortic valve replacement . Left - sided pacemaker device is re - demonstrated with leads terminating in the right atrium and right ventricle . Heart size remains moderately enlarged . Mediastinal contours are unchanged with diffuse atherosclerotic calcifications again noted . Mild pulmonary vascular congestion is slightly worse in the interval . Small left pleural effusion with associated atelectasis is present . Right lung remains otherwise grossly clear without new focal consolidation present . No pneumothorax is identified . Multilevel moderate degenerative changes are seen in the thoracic spine . Postsurgical changes within the left lower ribs are re - demonstrated with a bridged device again noted .
    OUTPUT:
    
Small left pleural effusion with associated left basilar atelectasis . Mild pulmonary vascular congestion , slightly worse in the interval .