I'm using the card in an external enclosure. In theory, I could have gotten required airflow but I decided to go alternative way.
It could have been a good option for a data center, but not for an office desk.
My next idea was to try liquid cooling. I got a GPU mounting bracket from NZXT and Corsair fan from e-bay.
The end result looks great and is quiet enough.
My noise baseline is the fridge. My laptop and the GPU enclosure are quieter than the fridge.
@benis it works. Temps are reach 70°C. I would go with a bigger radiator - 140mm or even one that hosts 2 or 3 fans. My current radiator is for a 120mm fan.
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