Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and anterior chest wall resection with metallic implants again noted bridging the sternal region . The right clavicle has been resected . Multiple clips are also seen within the right chest wall . Heart size is normal . Mediastinal and hilar contours are unremarkable . Elevation of the right hemidiaphragm is new compared to ___ , and there is a trace left pleural effusion . The pulmonary vasculature normal . No focal consolidation concerning for pneumonia is present . Scarring within the right upper lobe is re - demonstrated along with a few foci of calcifications . No pneumothorax or pleural effusion is present . Destruction of the 1st ribs bilaterally is again seen .
    OUTPUT:
    
Postsurgical changes from prior sternal and chest wall resection . Elevation of the right hemidiaphragm , new compared to ___ . Trace right pleural effusion .