Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are low lung volumes and associated bronchovascular crowding . There is bibasilar atelectasis , similar to prior exam . The lungs are otherwise clear . There is a small left pleural effusion , unchanged from prior . The cardiomediastinal silhouette enlarged , stable from prior exam . Median sternotomy wires and mediastinal clips are again noted . An old right rib resection is noted .
    OUTPUT:
    
No acute cardiopulmonary process .