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I don't know a lot about heatsink design, but the aluminum VRM heatsink on the X299E-ITX/ac seems pretty solid and actually designed to cool well with some fin-like structures. It looks better than some of the ATX boards. Unfortunately the riser card will block some airflow to it. I guess they can make it out of nickel-plated solid copper, which may add another $20-30 to the cost...