Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a moderate - to - large left - sided effusion , increased since the prior exam , along with volume loss . The prior pulmonary edema on the right appears to have resolved . A PICC has been removed . Trach collar is in place . Patient is status post median sternotomy with extensive vascular clips within the cardiomediastinum . No opacities concerning for an infectious process .
    OUTPUT:
    
Moderate - to - large left - sided pleural effusion , increased in size since the prior study .