I became concerned when I saw a post on eVGA's forums. Guy had heat issues, and took the stock heatsink off to find this...



As you can see, there is almost no thermal compound on the gpu itself, and the memory paste is showing scorching. I have little faith in the stock thermal compound at this point.
I would take the stock setup apart and apply AS5, but the memory uses thick thermal pads, and I don't want to have to deal with damaged pads as I don't have any replacements.
I've had heat issues with my first 8800gtx. While the lifetime warranty is great, exchanges take a while and it's a pain in the butt.
The aftermarket cooling doesn't void the warranty either, so I think I'm going to do this. From the comments I read, this cooler drops the temps 10 deg C across the board.
I was concerned about there being no exhaust out of the case as with the stock cooler, but I've ordered a Scythe 120mm high volume (63.7 cfm)/low noise (28 db max) fan for the exhaust that I'll put on the fan controller. The standard fan I'm using now isn't rated as high, and seems plenty capable of keeping up with the five intake 80mm fans I'm using. I'm thinking about adding an additional 80mm exhaust under the vid card. I also am not impressed with the stock cooler's exhaust volume. That might be the problem with the first card, it doesn't seem to move much air out the back at all though it's spinning...