Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral radiographs of the chest again demonstrate an enlarged cardiomediastinal silhouette , unchanged from ___ with intact median sternotomy wires and mediastinal clips . Prosthetic aortic and mitral valves are again noted . There is unchanged mild vascular congestion . No pneumothorax or pleural effusion is visualized . There is unchanged left basilar atelectasis . There is no other focal airspace consolidation .
    OUTPUT:
    
Mild vascular congestion , unchanged from ___ .