Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy , CABG , and aortic valvular replacement . Moderate - to - severe cardiomegaly is relatively unchanged compared to the prior study . The mediastinal contours are unchanged , with tortuosity of the thoracic aorta again noted . Previous pattern of pulmonary vascular congestion has resolved . The hilar contours are normal . Lungs are clear . No pleural effusion or pneumothorax is identified . No acute osseous abnormality is seen .
    OUTPUT:
    
Cardiomegaly without evidence of congestive heart failure .