Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated positioning , which considerably distorts in limits assessment of the cardiomediastinal silhouette . Allowing for this , there are sternotomy wires and a prosthetic valve , mid probable prominence of the cardiomediastinal silhouette . Possible prominence of the left pulmonary artery . Possible background COPD . There is mild vascular plethora . There is patchy opacity at the left lung base , consistent with collapse and / or consolidation . A small effusion would be difficult to exclude . Possible minimal blunting at the right costophrenic angle . Atelectasis at the right base can not be excluded .
    OUTPUT:
    
Sternotomy wires , with prosthetic valve . Allowing for significant rotation , I suspect there is enlargement of the cardiomediastinal silhouette . Probable background COPD . Probable mild CHF . Bibasilar atelectasis and possible small effusions . In the appropriate clinical setting , changes at the left base could include a pneumonic infiltrate .