Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy and aortic valve replacement . The patient also has an unchanged dual - lead pacemaker / ICD device with leads terminating in the right atrium and ventricle , respectively . The heart is moderately enlarged . Dense mitral annular calcifications are present . The mediastinal and hilar contours appear unchanged . The lungs appear clear . There are no pleural effusions or pneumothorax . Mild degenerative changes are noted along the thoracic spine . There is no evidence for free air .
    OUTPUT:
    
No evidence of acute disease .