Chest X-ray after mitral annuloplasty shows sternal wires, left atrial enlargement and prominent left atrial appendage (Third mogul sign).
Annotated picture is given below:
Prominent upper lobe vessels indicate pulmonary venous hypertension. Double atrial contour is the left atrial contour seen within the right atrial contour. Right atrium is also enlarged as indicated by the increased distance of the right atrial border from the midline. These findings might have been there prior to annuloplasty and not regressed well after the procedure.