FINDINGS:
The patient is status post CABG and median sternotomy.  Left-sided AICD device
 is noted with leads terminating in the right atrium, right ventricle, and
 coronary sinus, unchanged.  Moderate cardiomegaly persists.  The mediastinal
 and hilar contours are stable, with calcification of the thoracic aorta again
 demonstrated.  Mild pulmonary vascular congestion persists.  A small right
 pleural effusion persists, slightly decreased in size compared to prior chest
 radiograph.  Right basilar atelectasis is noted.  Subtle bilateral upper lobe
 nodular opacities which are better seen on the prior CT persist, and may
 reflect an infectious or inflammatory process.  No new focal consolidation is
 identified.  There are no acute osseous abnormalities.

IMPRESSION:
1. Small right pleural effusion, slightly decreased from the prior chest
 radiograph.
 
 2. Mild pulmonary vascular engorgement.
 
 3. Subtle ill-defined nodular opacities in both upper lobes, better seen on
 the prior chest CT persist, and may reflect an infectious or inflammatory
 process.