All these wierd-looking and elaborate heatpipe solutions are getting to the point that they are almost crazy. Factor in the dual-slot video cards in SLI taking up 4 out of the available 7 slots in a PC (5 if you also use a sound card) and you pretty much get to the point that today's ATX PC design is over-crammed, obsolete and in serious need of an overhaul.
Granted, that won't happen any time soon, and motherboard manufacturers pretty much have their hands tied in trying to keep mobo components cool while still staying within ATX specifications, allowing room to fit expansion cards, CPU heatsinks and ram.
Enthusiasts who really need good cooling won't hesitate to remove the heatpipe contraption and install an aftermarket NB/SB waterblock. Even for SLI where the second card sits above the SB, a low-profile block will fit under the 2nd graphics hard nicely, and if the graphics cards are water cooled (have the large factory cooler removed) you can route the tubing easier. Of course if the SB is out of the way of your 2nd graphics card installation will be much simpler. As for the CPU Vreg cooling, you can also get water blocks for those in various sizes, and they are not difficult to attach.
The X38 chipset already comes with a large heatspreader, and the dual-socket skulltrail platform will also require some pretty decent cooling.
I like the fact that Asus provides barbs on the NB, but I still don't think that it will be anywhere near as effective as a dedicated NB/SB/Vreg waterblock combination. Heatpipes can only do so much, 1/2" tubing is a space hog in itself, and heatsink fins only add heat inside the case.
When we get the point that we cannot cool things any more, component manufacturers will be forced to use more efficient manufacturing processes and bring down the power consumption of their chips. There's no reason why GPU and NB chips cannot be deployed on 45nm (or 32nm) if CPU's can be done for the sake of thermal efficiency. Advancements in carbon nanotubing may also play a big role in future CPU cooling.