How about a slow moving 80mm fan or a 60mm 5000rpm delta. If you have the $57 to spend you can get an Alpha peltier kit with a quiet fan from Leufkentechnologies. That should be enough to cool a video card!
I am implementing video card watercooling in my system.
Noise. I tend to reduce the airflow in my system down to a single 120mm fan (Panaflo H1A dialed down with rheostat). I will have the video card, motherboard, and cpu water cooled. RAM will have RAM sinks to improve heat dissipation.
Its not complicated to watercool your vid card. Just order a waterblock and use some common sense attaching it. Very similar to attaching a block to your processor. I ordered my blocks from BeCooling. If you have specific questions.. fire away.