Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy , CABG , and aortic valve repair . Left - sided dual - chamber pacemaker device with leads terminating in the right atrium and right ventricle are in unchanged positions . The heart size is normal . Pulmonary vasculature is normal . Mediastinal and hilar contours are unremarkable . Small bilateral pleural effusions are unchanged . There is minimal atelectasis in both lung bases . No focal consolidation or pneumothorax is present . There are mild degenerative changes noted in the thoracic spine .
    OUTPUT:
    
Small bilateral pleural effusions , similar compared to the previous exam .