Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been substantial interval increase in the moderate to large left pleural effusion following pigtail catheter removal . The sternotomy wires remain intact and aligned . Heart size can not be accurately assessed . Mediastinal contours are stable . There is no pneumothorax . The right lung is clear .
    OUTPUT:
    
Increased moderate to large left pleural effusion following pigtail catheter removal .