Looks like if you put it back as normal you will need some kind of setup to pull air threw the card, since it looks like your ram slots may be in the way of using a push type on the front.
Edit: you should be able to use two 40mm fans on the back of the case with zip ties.
Zip-tieing them to the case and video card pulling air thew the card.
Edit: Here I have a push/pull setup a 40mm on the top of the video card inside pushing and another 40mm on the back of the case pulling these being only 9,500 RPM fans. The card in use is a Tesla M40 that stays under full load 24/7 so it needs good cooling. With that P4 you may be able to get away with one pulling air if the RPM is high enough.
