Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Post - sternotomy and valve replacement changes are present . The heart size is at the upper limits of normal limits similar to prior exam . The mediastinal and hilar contours are within normal limits . The lungs are clear of consolidation or pulmonary edema . There is no large pleural effusion or pneumothorax . Degenerative changes are present throughout the thoracic spine , primarily in the form of anterior osteophytes .
    OUTPUT:
    
No evidence of pneumonia or heart failure .