Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are well expanded and clear . Marked enlargement of the cardiac silhouette is unchanged without signs of failure or vascular congestion . There is no pleural effusion or pneumothorax . Sternal closure wires are intact . Tortuous descending thoracic aorta is noted .
    OUTPUT:
    
Persistent marked enlargement of the cardiac silhouette without acute intrathoracic process . No significant interval change .