Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and type A aortic dissection repair with unchanged tortuous appearance of the mediastinal contour which is widened superiorly . Cardiac silhouette size remains moderately enlarged with a coronary artery stent again noted . Hilar contours are within normal limits . The pulmonary vasculature is not engorged . Lung volumes are lower compared to the previous radiograph . Patchy opacities in the lung bases likely reflect areas of atelectasis and scarring , not substantially changed in the interval . No pneumothorax is present however the medial aspect of both lung apices is obscured by the patient 's neck and chin projecting over this area . No large pleural effusion is seen . Moderate degenerative changes are noted in the thoracic spine with slight loss of height of several lower thoracic vertebral bodies , unchanged .
    OUTPUT:
    
Status post type A aortic dissection repair with unchanged widened and tortuous mediastinal contour . Patchy bibasilar airspace opacities likely reflect atelectasis and scarring .