Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Enlargement of the cardiac and mediastinal silhouettes is stable . Enlargement of the main pulmonary artery suggests underlying pulmonary hypertension . Patient is status post median sternotomy and cardiac valve replacement . There are small bilateral pleural effusions . Enlargement and indistinctness of the hila and mildly increased interstitial markings with mild bilateral patchy alveolar opacities suggest mild pulmonary edema . There are degenerative changes at the acromioclavicular and glenohumeral joints .
    OUTPUT:
    
Small bilateral pleural effusions and mild pulmonary edema . Persistent enlargement of the cardiomediastinal silhouette . Constellation of findings concerning for CHF .