Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Post - CABG mediastinal silhouette and mild cardiac enlargement is unchanged . Hilar contours are normal . Right atrial and right ventricular pacer leads are unchanged in position with interval addition of a left ventricular lead appropriately placed . Left pectorally implanted pacemaker is in place . Lungs are clear . There is no pneumothorax . Small bilateral pleural effusions are noted .
    OUTPUT:
    
Biventricular pacemaker leads in appropriate position without evidence of pneumothorax . Small bilateral pleural effusions .