Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided pacemaker is again seen with leads extending to the expected positions of the right atrium and right ventricle . The lungs are clear without focal consolidation . No pleural effusion or pneumothorax is seen . The cardiac and mediastinal silhouettes are stable . Subtle slight prominence of the ascending aorta is similar compared to prior , likely relates to mild ascending aorta ectasia as seen on prior CT .
    OUTPUT:
    
No acute cardiopulmonary process .