Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and CABG . Left - sided AICD / pacemaker device is noted with leads terminating in the right atrium , right ventricle , and coronary sinus , all in unchanged positions . The heart remains moderately enlarged . Tortuosity of the thoracic aorta is again seen , and the mediastinal contours remaining unchanged . No overt pulmonary edema is present . No focal consolidation , pleural effusion or pneumothorax is visualized . There are no acute osseous abnormalities . Old right - sided rib fractures are present .
    OUTPUT:
    
No radiographic evidence for congestive heart failure or pneumonia .