Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided AICD / pacemaker device is noted with leads terminating in the right atrium and right ventricle . The patient is status post median sternotomy and CABG . The heart size is top normal . The aorta is tortuous . Lungs are clear and the pulmonary vasculature is normal . No pleural effusion or pneumothorax is seen . Multilevel degenerative changes are seen within the thoracic spine . An aortic graft is partially imaged on the lateral view .
    OUTPUT:
    
No acute cardiopulmonary process .