Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the prior radiograph , there has been no significant change . There is no focal consolidation , pleural effusion , or pneumothorax . Pulmonary vasculature is unremarkable . Median sternotomy wires are intact . There are surgical clips overlying the heart . Osseous structures are unremarkable .
    OUTPUT:
    
No acute pulmonary process .