Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate cardiomegaly , pulmonary vascular engorgement , and extensive pleural calcifications are unchanged . A small left effusion and atelectasis are similar . Right chest pacemaker leads are in appropriate position . Incidental note is made of an azygos fissure . A PICC line previously seen in a duplicated left SVC has been removed . A new right - sided PICC line has been placed into the low SVC .
    OUTPUT:
    
Stable mild pulmonary vascular engorgement . Removal of left picc in duplicated IVC and new right PICC .