FINDINGS:
In comparison with the study of , the IJ catheter has been
 removed and replaced with a right subclavian catheter that extends to the
 lower portion of the SVC.  Continued enlargement of the cardiac silhouette
 with pacer-defibrillator in place.  Mild indistinctness of pulmonary vessels
 could reflect some elevated pulmonary venous pressure.  The retrocardiac area
 is not optimally seen, though there is only mild atelectasis.  Bilateral chest
 tubes are in place and there is no evidence of pneumothorax.