Hey BrianH,
BTW, welcome to AT!
Well, first of all let me just ask you one question, why are you looking at the P5K-V while the P5K since you may disable the video? Any specific reason, or feature that the P5K-V has that the P5K does not? Because the P5K is cheaper. But anyways...
About your questions...
The heatpipe is not just cosmetic, it really helps. It only will not help if you use a BTX case, that you will have to build the mobo up side down.
About the IDE, since Intel dropped the IDE support in the ICH8, manufactures had to put third party IDE controllers, which most of them use JMicron. And put only one IDE port. And the ICH8, ICH9, and probably the future southbridges from Intel will only support SATA.
Yeah I must agree with you that Asus has not done a good job with the design of the mobo.
But you might check other P35 mobo manufactures, Abit IP35-E uses the same chipset, has a better placed IDE port and it is cheaper than the Asus. But you will loose the heatpipe, what it is not all that bad at all.
Hope this helps you!
Rafael