One of the big problems I've had with modern high end video cards is that they tend to have 2-slot cooling solutions and are extremely noisy in full-load operation. ATI's X1900XTX, while a great card, makes so much noises in a open case it's not even funny. The card performs great, has excellent image quality in every game and has the most stable drivers around, but the noise can be distracting.
ATI and NVIDIA form a duopoly in the standalone graphics card market today. Both of their highest end cards require two slots to allow for their cooling solutions. NVIDIA cards have had fans since the early days with the TNT2 Ultra and ATI cards have had cooling fans since the first RADEON in 2000. ASUS builds video cards based upon both NVIDIA and ATI chipsets. Today I'm reviewing the ASUS EN7800GT Silent video card based on an NVIDIA G70 chipset.