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IMPRESSION:

1. A very large SVG graft aneurysm. This SVG graft, likely involves the SVG going from the ascending aorta to obtuse marginal coronary artery. Given the calcifications and differential density, this is likely a thrombosed aneurysm.
2. Ascending aorta is normal in dimension without ectasia or aneurysm.
3. No pericardial effusion.
4. Severe dense native coronary artery calcifications.
5. Emphysema.
6. Moderate to large left pleural effusion with compressive collapse of the left lower lobe.