FINDINGS:
The patient is status post median sternotomy, aortic valve replacement, and
 CABG.  Heart size is normal.  Mediastinal contours are unchanged with
 tortuosity of the thoracic aorta again noted.  Calcification of the aortic
 arch is again seen.  There is no pulmonary vascular congestion.  Hilar
 contours are normal.  Lungs are clear without focal consolidation.  Previously
 noted bilateral pleural effusions have nearly completely resolved with only a
 trace left pleural effusion identified.  No pneumothorax is seen.  There are
 multilevel degenerative changes in the thoracic spine.

IMPRESSION:
Trace residual left pleural effusion.  Otherwise, no acute cardiopulmonary
 process.