FINDINGS:
The patient is status post median sternotomy and cardiovascular
 surgery.  Sternal wires are absent.  Cardiac silhouette is stable in the
 post-operative period, but mediastinal width has slightly decreased, with
 associated slight improvement in extent of pulmonary edema, now moderate in
 severity.  Bilateral chest tubes remain in place, with no definite
 pneumothorax.  Prominent lucency adjacent to left cardiac silhouette contour
 may reflect post-operative pneumopericardium, less likely a medial left
 pneumothorax.  Attention to this region on short-term followup radiograph
 would be helpful.