IMPRESSION:
1.  Right subclavian PICC line unchanged in position.  Status post median
 sternotomy.  The heart remains markedly enlarged, most likely reflecting
 cardiomegaly, although a pericardial effusion cannot be entirely excluded. 
 There continues to be more focal patchy opacity in the right mid and lower
 lung, which may reflect areas of patchy atelectasis, although pneumonia cannot
 be entirely excluded.  A more focal nodular opacity in the left mid lung is
 once again apparent and may represent an area of loculated fluid or patchy
 atelectasis.  There is cephalization of the vasculature consistent with
 pulmonary venous hypertension, but no overt pulmonary edema is present at this
 time.  No large pleural effusions.  Retrocardiac streaky opacities likely
 reflect atelectasis.  No pneumothorax.