Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and mitral valve replacement . The lungs are hyperinflated , compatible with underlying COPD . The heart size is moderate to severely enlarged . There are ill - defined opacities at the lung bases . Small bilateral pleural effusions may be present . There is scarring within the lung apices . No pulmonary vascular engorgement is noted . There is diffuse calcification of the thoracic aorta .
    OUTPUT:
    
Ill - defined opacities at the lung bases may reflect infection or aspiration . There may be trace bilateral pleural effusions . COPD .