Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A new right internal central jugular venous catheter terminates in the lower superior vena cava . There is no evidence for pneumothorax . The heart is again mild - to - moderately enlarged . The aorta is tortuous and calcified . The patient is status post aortic valve replacement . Mild background pulmonary vascular congestion appears similar to somewhat increased , with a small right - sided pleural effusion that has a shifting distribution but is probably similar in size . Similar patchy lower lung opacities suggest minor atelectasis or scarring and appear similar . Focal nodular density projecting over the left lower lung suggests a nipple shadow that is unchanged .
    OUTPUT:
    
1 . Satisfactory positioning of right internal central jugular venous catheter without evidence for pneumothorax . 2 . Similar patchy opacities that are probably chronic in addition to a small persistent right - sided pleural effusion .