Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient had AVR and MVR with ___ valves . Cardiac contour enlargement is moderate and has increased since ___ . Left atrium is dilated with double contour of the right heart border . The lungs are otherwise clear . The mediastinal contour is unremarkable . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
1 . There is no evidence of sarcoid . 2 . Moderate cardiomegaly has worsened since ___ .