FINDINGS:
There is a severe levoconcave scoliosis of the thoracic spine.  The
 compensatory dextroconcave scoliosis of the lumbar spine is not included on
 this radiograph as in priors.  The lungs, however, remain clear without
 consolidation or edema.  Evidence of prior median sternotomy and CABG noted. 
 The cardiac silhouette size is stable.  There is suggestion of blunting
 posteriorly of the left costophrenic angle which has been noted on prior exams
 may be due to chronic effusion or scarring.  No right effusion is noted. 
 There is no pneumothorax.  No displaced fractures are evident.

IMPRESSION:
Severe scoliosis.  No definite acute pulmonary process noted. 
 There may be a small left pleural effusion.