TrustedReviews posted a review of the Asus EN7800GT Top Silent graphics card.

Rather than going down the Zalman route - a design that a lot of other manufacturers have copied with varying results - and run the heatpipes from the GPU to the back of the graphics card, Asus has a much more interesting solution. Although it looks as if the heatpipe is located just above the card at first, this is not the case. What Asus has done is to create a solution that allows you move the heatpipe 45 degrees.

Asus EN7800GT Top Silent Review