Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and mitral valve replacement . Stable cardiomegaly and tortuosity of the thoracic aorta . Pacing leads are unchanged in position . Lungs are hyperinflated but grossly clear except for an unchanged calcified granuloma in the right mid lung . Multiple bilateral healed rib fractures with adjacent pleural thickening appears similar to the prior radiograph .
    OUTPUT:
    
Hyperinflation consistent with history of COPD . No radiographic evidence of pneumonia .