What I've done is just make a big hole where the heatsink goes, big enough to solder the heatsink from the other side after the part's other pins are soldered. With a big blob of solder paste in the hole and a bit of copper wire, you can get the properties you need. If the remainder of the component-side copper of the heatsink is pre-reflowed to the chip, that's even better.
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Re: [Homebrew_PCBs] How to tackle thermal pads on SMT packages?
2013-07-10 by DJ Delorie