Pulmonary Vein Thrombosis (PVT) is a rare and insidious condition with only few case series and case reports described in literature. PVT effects on pulmonary circulation is similar to mitral stenosis and its haemodynamic consequences depend on the number of veins involved, the obstruction severity and the pulmonary vessels compliance. Here we present a case in which a multimodality approach with Transesophageal Echocardiography (TEE) and Computed Tomography (CT) imaging helped to guide therapeutic decisions. Specifically, a post-processing reconstruction of TEE projection directly from CT imaging was performed.