endotracheal tube and left-sided pacer unchanged in position. a nasogastric tube is seen coursing below the diaphragm with the tip not identified. the right internal jugular central line has been replaced with a new line terminating in the proximal to mid svc. the left internal jugular central line has been replaced and the tip is now in the distal subclavian vein near its junction with the superior vena cava. the patient is status post median sternotomy with mitral valve replacement and cabg with stable postoperative cardiac enlargement. retrocardiac consolidation and right medial and infrahilar opacities are stable. probable layering left effusion. no pulmonary edema. no pneumothorax.