Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Midline sternotomy wires are again noted with prosthetic cardiac valves again seen . Previously noted right IJ central venous catheter is been removed there has been placement of a left chest wall Port - A - Cath with tip in the mid SVC region . The heart is moderately enlarged . There is persistent consolidation at the right mid to lower lung with moderate right pleural effusion which appears partially loculated . Prominence of the mediastinum appears grossly unchanged . The left lung remains clear . Bony structures are noted to be sclerotic with a rugger ___ appearance , suggestive of renal osteodystrophy .
    OUTPUT:
    
Persistent moderate cardiomegaly with loculated moderate right pleural effusion and consolidation in the right mid and lower lung . Overall , no significant change from prior exam . Port - A - Cath positioned appropriately and previous right IJ central venous catheter removed in the interval .