Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs remain hyperinflated but clear . The heart is moderately enlarged , as before . The descending aorta is tortuous . Surgical clips are again noted projecting over the upper abdomen . There is no free air under the diaphragm . No large effusion or pneumothorax is present .
    OUTPUT:
    
Moderate cardiomegaly . No free air under the diaphragm .