Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Large left and small right pleural effusions are both slightly larger when compared to prior . The lungs are otherwise clear . Cardiac silhouette can not be assessed given silhouetting , particularly on the left . Abnormal contour of the left mediastinum at the AP window is somewhat more pronounced when compared to prior . Prosthetic aortic valve and median sternotomy wires are again noted .
    OUTPUT:
    
Bilateral pleural effusions , large on the left and small on the right are slightly larger compared to prior . Abnormal contour projecting over the AP window is more conspicuous on the current exam and while this could be due to loculated pleural fluid , change in the contour of the aorta with known underlying dissection is possible and should be assessed by CTA which is already ordered .