Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Median sternotomy changes and mediastinal vascular clips are new since the prior study from ___ , with fracture of the superior and inferior - most closure wires . Lungs are well - expanded and clear . The heart size is normal . No pleural effusion , pulmonary edema , pneumothorax , or focal consolidation is identified .
    OUTPUT:
    
No acute cardiopulmonary process .