Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Overall , appearance is similar compared to prior . There are small bilateral pleural effusions , larger on the left , with associated atelectasis . There is mild pulmonary vascular congestion without overt edema . Calcified left hilar nodes are again noted . Cardiomediastinal silhouette is otherwise grossly unremarkable . Prosthetic mitral valve is noted as well as median sternotomy wires . Prior right PICC is no longer visualized . Anterior cervical fixation hardware and surgical clips in the right upper quadrant are again noted .
    OUTPUT:
    
Persistent bilateral pleural effusions , not significantly changed .