Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Given differences in positioning since prior , there is no significant interval change . Right apical scarring is again seen . The lungs are otherwise clear noting that the left costophrenic angle is excluded from the field of view . Cardiomediastinal silhouette is within normal limits . Median sternotomy wires and mediastinal clips are again noted .
    OUTPUT:
    
No acute cardiopulmonary process .