Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A large - bore right - sided central venous catheter tip sits in the mid SVC . Sternotomy wires are unchanged . Mediastinal contours are unchanged and the heart size is likely large but masked by bilateral large pleural effusions with associated atelectasis , similar in extent to the prior exam from earlier this morning . The prosthetic valve is minimally perceptible . Clips are present in the left axilla . There is no pneumothorax . The degree of pulmonary edema within the lungs is unchanged .
    OUTPUT:
    
Unchanged appearance of bilateral pleural effusions with associated atelectasis .