Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Prior right - sided central venous catheter is no longer visualized . Left chest wall dual lead pacing device is noted with lead tips in the right ventricular apex and right atrium . Aortic core valve device is again seen . There is a moderate left pleural effusion , increased from prior . Small right pleural effusion is noted , not dramatically changed . Superiorly , the lungs are clear besides biapical scarring . The cardiomediastinal silhouette is stable . Surgical clips project over the left upper quadrant .
    OUTPUT:
    
Interval increase in size of left pleural effusion . Persistent small right pleural effusion .