Trusted Reviews looked at the Sapphire Liquid Cooled Radeon X1900 XTX TOXIC

Clock speeds aside, what makes this card unique is its cooling
solution. Instead of the reference air cooler that is so noisy noisy that I keep a
set of ear plugs in my desk drawer, Sapphire has chosen to use a self-contained liquid cooling kit. As you can see, the actual cooler and the card are separate units, so it will require a spare expansion slot to accommodate this. The main graphics card has nothing but a waterblock on it, while the cooling unit contains the reservoir, pump, copper radiator and cooling fan. It is pre-filled, so you're ready to go straight out of the box. But if you need to top up the coolant or even replace it this is easily done.

Sapphire Liquid Cooled Radeon X1900 XTX TOXIC Review