Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The newly placed a left IJ approach central venous catheter tip projects over the expected region of the cavoatrial junction . A left single lead pacer defibrillator tip projects over the expected region of the right atrium . Cardiac valve replacement , median sternotomy wires , and mediastinal clips are unchanged . Lung volumes remain low . Blunting of the costophrenic angles bilaterally suggests small bilateral pleural effusions . No pneumothorax or frank pulmonary edema . The cardiomediastinal silhouette is unchanged .
    OUTPUT:
    
1 . Newly placed left IJ approach central venous catheter tip projects over the expected region of the cavoatrial junction . 2 . Persistent low lung volumes . 3 . Persist and bilateral small pleural effusions .