Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is normal . The patient is status post median sternotomy and aortic valve replacement . There is massive dilatation of the entire thoracic aorta , compatible with known thoracic aortic dissection and aneurysmal dilatation as seen on the prior CTA . Pulmonary vascularity is normal and the lungs are clear . No pleural effusion or pneumothorax is present . There are no acute osseous abnormalities . The lungs appear mildly hyperinflated with relative lucency at the lung apices , compatible with known paraseptal emphysema . No acute osseous abnormalities are seen .
    OUTPUT:
    
Unchanged massive dilatation of the entire thoracic aorta compatible with known aneurysm and Type A dissection . No radiographic evidence for pneumonia or congestive heart failure .