Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to prior , there is no significant change . Severe cardiomegaly is a stable . The pulmonary vasculature is mildly engorged , however no pulmonary edema is seen . Small left pleural effusion is seen . The lungs are low in volume , but clear . Left ventricular assist device , left - sided pacemaker , sternotomy wires are intact and unchanged in position .
    OUTPUT:
    
Small left pleural effusion . No pneumonia .