Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the prior film , multiple lines and tubes have been removed . The right IJ Swan - Ganz catheter is been converted to right IJ sheath , with tip over distal most SVC . The two prosthetic valves are noted . The cardiomediastinal silhouette is again noted to be prominent , consistent with recent surgery . Although it appears more pronounced than on the prior film , this may relate to technical differences . On today 's exam , there is more pronounced vascular plethora , with diffuse vascular blurring , consistent with CHF . Again seen is patchy retrocardiac opacity . Possible small bilateral effusions . No pneumothorax detected .
    OUTPUT:
    
Interval removal of multiple lines and tubes . Apparent interval increase in CHF . Patchy retrocardiac opacity similar to prior .