Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and cardiac valve replacements . The cardiac silhouette remains enlarged , similar to prior . There is moderate to large right pleural effusion which appears slightly increased as compared to the prior study , with overlying atelectasis . Right basilar consolidation is difficult to exclude . No pneumothorax is seen on the current study .
    OUTPUT:
    
Moderate to large right pleural effusion with overlying atelectasis , underlying consolidation is not excluded . Persistently enlarged cardiac silhouette .