Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the most recent examination there has been development of small bilateral apical pneumothoraces . In addition there has been development of a small left layering pleural effusion . There is unchanged pulmonary vascular congestion with no new focal opacities concerning for pneumonia . The cardiomediastinal and hilar contours are stable , demonstrating stable cardiomegaly . The patient is status post median sternotomy and aortic valve replacement . In addition the patient is status post bilateral chest tube placement . Diffusely sclerotic bones are re-demonstrated . There has been interval removal of the right internal jugular approach Swan - Ganz catheter .
    OUTPUT:
    
1 . Small bilateral apical pneumothoraces new since ___ . 2 . Diffuse sclerosis of the bones , for which clinical correlation for sclerotic metastases is advised as previously noted .