interval removal of the left chest tube with no pneumothorax appreciated; however, the sensitivity to detect pneumothorax is diminished given supine technique. if this remains of clinical concern, followup imaging in the upright or decubitus position would be advised. endotracheal tube, right internal jugular introducer, and right internal jugular swan-ganz catheter are unchanged in position. nasogastric tube courses below the diaphragm with the tip not identified. overall cardiac and mediastinal contours are stable status post median sternotomy with valve replacement. lungs appear grossly clear. no overt pulmonary edema.