The purpose of this trial is to evaluate safety and efficacy of a pericardial adipose pedicle transposition (adiFLAP) for the improvement of cardiac function in patients with a chronic myocardial infarct. Preclinical studies in the porcine model of myocardial infarction have shown that AdiFLAP reduces infarct area.

This novel intervention consists of the pericardial isolation of adipose tissue maintaining its vascularization to create an adipose flap (adiFLAP) and its transposition fully covering infarcted myocardium.

Inclusion Criteria:

• Established transmural myocardial infarction non candidate to revascularization (>3 months-old)
• Candidate to coronary by-pass for other territories different from the previous transmural infarct.
• > 18 years of age, male or female, capable of giving an informed consent.

Exclusion Criteria:

• Severe co-morbidity associated with a reduction in life expectancy of less than 1 year.
• Severe valvular disease candidate for surgical restoration.
• Candidate to ventricular remodeling.
• Contraindication for NMR (creatinin clearance <30 ml/min/1.73m2, metallic implants, claustrophobia).
• Severe renal or hepatic failure.
• Abnormal laboratory tests (no explanation at the time of inclusion).
• Previous cardiac intervention.
• High surgical risk (Euroscore 2).
• Pregnant or breast feeding women.