Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal radiograph of the chest in patient that has had medial sternotomy for CABG and AVR , sternal wires are intact . Swan - Ganz catheter and endotracheal tube have been removed . Mediastinal drains are unchanged . Left axillary pacemaker has leads following the expected course and ending in the right atrium and right ventricle respectively . Right jugular catheter ends in upper SVC . Lung volume is low but with improvement of vascular congestion , especially to the left . There been interval increase of left pleural effusion . There is no pneumothorax .
    OUTPUT:
    
Left axillary pacemaker is normally positioned without evidence of pneumothorax . Interval increase of left pleural effusion with mild improvement of vascular congestion to the left . Swan - Ganz and ET have been removed .