Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and prosthetic aortic valve . Heart size remains mildly enlarged . The mediastinal and hilar contours worse similar . Pulmonary vasculature is normal . Lungs are clear without focal consolidation . No pleural effusion or pneumothorax is present . Multiple sclerotic foci are again noted within the osseous structures compatible with known metastatic disease .
    OUTPUT:
    
No acute cardiopulmonary abnormality .