Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Median sternotomy wires , LVAD device , and left chest wall pacemaker are again seen in unchanged position . There is stable , severe cardiomegaly . New , bilateral , ill - defined , perihilar infiltrates are consistent with mild - to - moderate pulmonary edema . There is no pneumothorax . Focal opacity at the left base could reflect alveolar edema , although underlying pneumonia can not be definitively excluded . New , mild blunting of the right costophrenic angle is consistent with a small right pleural effusion .
    OUTPUT:
    
Stable , severe cardiomegaly with new , mild - to - moderate pulmonary edema and a small right pleural effusion .