FINDINGS:
A left-sided pacemaker and multiple leads are in unchanged position. 
 Right-sided PICC terminates at the cavoatrial junction as before.  A left
 ventricular assist device projects over the lower left hemi thorax.
 
 A left basilar opacity is stable from  which likely reflects a
 combination of a left pleural effusion and adjacent compressive atelectasis. 
 There is minimal atelectasis at the right base which is stable.  No
 pneumothorax.  The cardiomediastinal and hilar contours are unchanged.

IMPRESSION:
Left-sided pleural effusion and pulmonary opacity is unchanged.  Minimal right
 basal atelectasis.  No pneumothorax.