There is a really simple solution to this. I happen to have an acrylic door on the side of my case. I drilled a hole, and installed an 80mm fan directly on top of the video card. I have a Leadtek 6600GT that idles at 40C, and is at 60C under load. It is overclocked to 570/1170. If you have a case with an aluminum side panel, you can always dremel it. It is the cheapest upgrade to cool a video card, though not the most aesthetic. I can show some pictures if you are interested.