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Adjunct Faculty

Adjunct faculty typically have an academic or research appointment at another institution and contribute or collaborate with one or more School of Medicine faculty members or programs.

Adjunct rank details

Nimrat Grewal, MD, PhD

Associate Professor Adjunct of Surgery (Cardiac)
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Associate Professor Adjunct of Surgery (Cardiac)

Biography

Professor Dr. Nimrat Grewal is a board-certified cardiothoracic surgeon and physician-scientist specialized in aortic surgery, with a Professor (Adjunct) appointment in Cardiac Surgery at Yale School of Medicine and at Amsterdam University Medical Center. Her program integrates a clinical practice in thoracic aortic surgery with translational research on the pathogenesis and risk stratification of thoracic aortic aneurysm and dissection (TAAD).

She received her MD cum laude from VU University Medical Center, Amsterdam, and her PhD from the Department of Anatomy and Embryology and Cardiothoracic Surgery, Leiden University Medical Center, where she characterized the developmental and molecular basis of bicuspid aortic valve (BAV)–associated aortopathy. This work framed the aortic wall in BAV and heritable thoracic aortic disease (HTAD) as a developmentally immature, prematurely degenerative tissue, implicating impaired vascular smooth muscle cell maturation, altered TGF-β signaling, and epicardial– and neural crest–derived contributions to medial degeneration.

Her current research applies an integrated multi-omic strategy to identify the genetic and cellular determinants of aortic wall failure and to define actionable targets for pharmacologic therapy. Her TARGet Biobank consists of a longitudinally annotated collection of more than 1,000 aortic tissue, cell, and blood specimens that she founded and subsequently scaled into the department-wide, nationally and internationally distributed IHLCN biobank infrastructure. She combines genome-wide association studies (GWAS) and rare- and structural-variant analysis with single-nucleus RNA sequencing to resolve disease-associated genes and cell states within the aortic media. Candidate loci and pathways are then interrogated functionally in patient-derived and induced pluripotent stem cell (iPSC)–derived vascular smooth muscle cell models, enabling both refinement of individualized risk stratification and pathway-based discovery of candidate drug compounds for a disease currently managed by prophylactic surgical replacement alone.

She is Principal Investigator of GEN-TAAD, one of the largest international genetic consortia in thoracic aortic disease, and of APECx, a global clinical-trial platform spanning more than 60 centers across 35 countries that characterizes international variation in cardiac surgical, anesthetic, and perfusion practice. She additionally leads fundamental, genetic, and clinical-trial projects and directs the TRAIN Health Awareness platform (www.trainhealthawareness.com) for cardiovascular prevention. She serves as the Dutch national expert for HTAD within the European VASCERN network and co-leads the Dutch National Aortic Expertise Center. Her program is committed to open science and patient data donation, and her funding includes the Dutch Heart Foundation Dekker Senior Clinical Scientist Award, of which she was the first cardiothoracic surgeon recipient, among millions of euros in competitive support.

Her work emphasizes equity and co-creation with patients: study design incorporates patient input through the TRAIN platform and the Dutch Aortic Dissection Association, and her cohorts deliberately include women and ethnic-minority populations historically underrepresented in cardiovascular research. As one of the few women in cardiothoracic surgery, she mentors students, residents, PhD candidates, and junior faculty and is committed to a more inclusive surgical and scientific community.

Last Updated on June 22, 2026.

Departments & Organizations

Education & Training

University Teaching Qualification (BKO)
Amsterdam UMC (2024)
Resident in training (2016-2021)
Leiden University Medical Center, Leiden, the Netherlands. (2021)
Resident not in training (2014-2015)
Leiden University Medical Center, Leiden, the Netherlands. (2015)
PhD
Leiden University Medical Center, Leiden, the Netherlands., Department of Anatomy and Emryology and Department of Cardiothoracic Surgery (2015)
MD
VU University Amsterdam (2013)

Advanced Training & Certifications

ECFMG Certification (USMLE Step 1, Step 2 CK & Step 2 CS)
ECFMG (2017)

Research

Overview

Professor Grewal's research program spans the full translational arc of thoracic aortic aneurysm and dissection (TAAD), from molecular mechanism to individualized prediction, equitable infrastructure, and long-term recovery.

Its foundation is the genetic and cellular dissection of aortic wall failure. Through GEN-TAAD, an international genetic consortium, and complementary programs such as GENIE-TA (whole-genome sequencing with epigenomic annotation in young patients without an identified mutation), AGENT-TAD (genome-wide discovery beyond the recognized syndromes), and UNRAVEL-GEN (fundamental study of vessel-wall weakening), she is mapping the monogenic, polygenic, and structural-variant architecture of the disease. These findings are resolved at cellular resolution by single-nucleus RNA sequencing of the aortic media and interrogated functionally in patient-derived and induced pluripotent stem cell–derived vascular smooth muscle cell models, which she uses both to validate candidate pathways and to screen for compounds able to arrest aneurysm progression. Related work extends this lens across vascular beds through an integrative genomic and cellular analysis of shared and distinct mechanisms in coronary, abdominal, and thoracic aortic disease, and through studies of the sex-specific mechanisms underlying the male predominance of bicuspid aortic valve aortopathy.

A second line translates these insights into precision risk stratification and clinical decision-making that move beyond aortic diameter, including ICRPA (a multi-omics and clinical decision-support approach to personalized risk stratification), polygenic risk modeling, the GENIALITY trial for prevention of postoperative atrial fibrillation, and APECx, a global platform spanning more than 60 centers across 35 countries that characterizes international variation and socioeconomic and sex-based disparities in surgical, anesthetic, and perfusion practice. Artificial-intelligence and real-world-data efforts, among them Rehab@AI, biosensor-based monitoring, and large-scale analyses of elective cardiac-surgery outcomes, further support data-driven prediction and care.

Underpinning this work is a commitment to shared, inclusive research infrastructure and open science. The TARGet Biobank, which she founded and scaled into the department-wide IHLCN infrastructure, is complemented by national and inclusive data-donation initiatives such as HEART-NL, OPEN HEARTS, and INCLUDE, and supported by successive awards championing responsible data sharing and patient data donation.

Equity is a defining theme. Through Heart for Women, Reducing Health Inequalities, culturally tailored and health-literacy–based care in thoracic aortopathy, community prevention programs for people with a migration background, citizen-science studies, and the deliberate inclusion of underrepresented groups and aortic cohorts, she works to close longstanding representation gaps in cardiovascular research.

Finally, her program addresses prevention and survivorship, care beyond the operation. The TRAIN Health Awareness platform delivers personalized primary, secondary, and tertiary prevention, and patient co-created interventions support psychosocial recovery after dissection, including After the Storm and Rust na de Storm (hypervigilance and quality of life), a digital narrative-rehabilitation application, the THRIVE program for living with chronic pain, and physical-activity and nature-based wellbeing initiatives.

Research at a Glance

Yale Co-Authors

Frequent collaborators of Nimrat Grewal's published research.

Publications

2026

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