120mm side blowhole works wonders!

Or how about this: spray the back side with several coats of clearcoat for electrical insulation, put a big blob of Radio Shack heatsink compound on, and set the heatsink on it. Maybe attach the heatsink with a ziptie. Or if you don't mind spending some money, pick up some non-electrically-conductive thermal epoxy and use that. Brush on a thin coat and let it cure, to serve as an insulation layer, then attach the heatsink with more epoxy.
Keep in mind that video cards run hot these days. I seem to recall ELSA having a special utility for their GeForce 1 cards that would underclock the GPU to cool it
if it exceeded 100 degrees Celcius. That is 212F! Obviously the chips are able to take a lot of heat without suffering damage.