Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy with multiple intact and aligned sternal wires . A mitral valve prosthesis is unchanged . There is dense calcification throughout the aortic arch extending into the descending thoracic aorta . The mediastinal contours are prominent , but stable . There is slight deviation of the trachea to the right by the aortic knob . The cardiac silhouette is moderately enlarged but unchanged . A chronic moderate left pleural effusion is unchanged with opacification at the left lung base , likely reflecting associated compressive atelectasis of the left lower lobe . A small right pleural effusion is increased from ___ . The lungs are otherwise relatively clear without new focal airspace opacity . No pneumothorax is detected . There is mild pulmonary vascular congestion . An exaggerated thoracic kyphosis is noted with hypertrophic degenerative changes at the thoracic spine . Degenerative changes of the right shoulder joint are also noted .
    OUTPUT:
    
1 . No new focal airspace opacity . 2 . Chronic moderate left pleural effusion with underlying atelectasis . Superimposed infection can not be excluded in the appropriate clinical context . 3 . Slightly increased size of small right pleural effusion from ___ . 4 . Mild pulmonary vascular congestion .