結果：全例パルスオキシメーターを装着していた。初発徴候（重複あり）はチアノーゼが13 例，SpO2 低下が13 例， 多呼吸が8 例，心雑音が1 例であった。診断方法は胎児診断が1 例，遠隔診断が2 例，往診が6 例，搬送後診断が 3 例，当院で出生・診断が2 例であった。14 例中2 例が生後72 時間以降に診断された。この2 例は地域中核病院 で出生し先天性心疾患を疑われたが，精査過程で確定診断に至らず，肺静脈閉塞を合併していた1 例が肺出血し， ショックになった。
結語：総肺静脈還流異常の診断は専門的な心エコーの知識や技術を必要とするため，遠隔診断など確定診断しやす い体制の整備が必要である。
Patients and Methods：This retrospective cohort study included 14 isolated TAPVC patients （age：0 ～ 60 days） born in Iwate prefecture and treated at Iwate Medical University from 2008 to 2018. A pulse oximeter was used for all the patients. The first clinical symptoms were cyanosis in 13 patients, low pulse oximeter oxygen saturation in 13, tachypnea in 8, and heart murmur in 1 patient（ the symptom was duplicated）. Definitive diagnosis by echocardiography was achieved prenatally in 1 patient, during telemedicine in 2, during our hospital doctor visit to another hospital where the patients were born in 6, after transport to our hospital in 3, and after birth in our hospital in 2 patients. Two of the 14 patients had a delayed diagnosis （diagnosis at ＞72 hours of birth）. These 2 patients were born at a secondary-level maternity unit and were suspected of having critical congenital heart disease；however, their conditions were missed during clinical assessment, and one of them died of pulmonary venous obstruction.
Conclusion：As advanced echocardiographic techniques and knowledge are required to diagnose TAPVC, it is necessary to establish a system, such as telemedicine, for enhancing early and accurate diagnosis.
