Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post aortic valve replacement surgery . A dual - lead pacemaker / ICD device has the leads terminating in the right atrium and ventricle , respectively . A moderate to large hiatal hernia is noted although better seen on the prior examination , probably unchanged . Associated streaky opacities at the left lung base suggeste minor associated atelectasis . There are no pleural effusions or pneumothorax . Moderate degenerative changes are similar along the lower thoracic spine . There is a similar mild biconcave compression deformity along a few lower thoracic vertebral bodies , probably associated with bony demineralization .
    OUTPUT:
    
No evidence of acute disease . Moderate to large hiatal hernia .