Saddle chest is a relatively uncommon type of complex chest wall deformities characterized by distinctive morphological features. Therefore, to clearly distinguish it from other general complex deformities during diagnosis and treatment, Dr. Wenlin Wang named this specific condition “saddle chest.”

The main characteristic of saddle chest is the presence of symmetrical indentations on each side of the lower chest wall. The two depressions are not connected. Instead, they are separated by the normal height of the chest wall in the center, giving the overall chest wall the appearance of a saddle. Therefore, saddle chest is essentially a combination of two depressions of lateral chest wall.

The exact cause of primary saddle chest remains unclear. It may be associated with the development and advancement of Harrison’s groove; nevertheless, not all instances of primary pectus carinatum are correlated with Harrison’s groove.

Secondary saddle chest commonly develops after the Nuss procedure for pectus excavatum, representing a common complication of the surgery.

When the depressions are severe and compress the heart and lungs, patients may experience symptoms such as chest tightness, palpitations, chest pain, and even breathing difficulty. Additionally, the physical appearance of the malformation often causes feelings of inferiority in many patients, and can sometimes lead to varying degrees of psychological issues.

Diagnosis primarily involves a physical examination by observing the appearance of the chest wall, supplemented by imaging examination such as X-ray, chest CT scan, and three-dimensional reconstruction imaging. 

Wang procedure/Wung procedure

To correct the depressions on both sides of the chest wall, either the Wang procedure or the Wung procedure will be performed twice, requiring only one bar to complete the operation. This surgical approach significantly simplifies the operative process, reduces the risks and complexity of the surgery, and can achieve more ideal corrective outcomes.

Open Surgery:

This surgery involves using MatrixRIBs to extend and shape segments of the ribs or costal cartilage on both sides of the chest wall. The shaping material used does not require removal, thereby averting the need for subsequent surgery and associated discomfort.