Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is redemonstrated with leads terminating in right atrium and right ventricle . Patient is status post median sternotomy and CABG . Moderate enlargement of the cardiac silhouette is redemonstrated , or is tortuosity of the thoracic aorta . Pulmonary edema is worse when compared to the prior exam , with small bilateral pleural effusions , left greater than right . There is chronic pleural thickening and scarring / atelectasis in the right lung base . There is no pneumothorax . No acute osseous abnormality is seen . There is evidence of prior aortic valve replacement .
    OUTPUT:
    
Mild congestive heart failure with small bilateral pleural effusions .