Well, forget about the PCX5900. It's pretty much laughable in DX9. But since you named the PCX version, I'll assume you are using PCI-E. (That should've tipped most of you off

)
Anywho, as far as the little debacle over video cards, I've seen most 6600GTs w/ 128MB of ram, and to be honest, that's all they really need, as they're a bit limited power-wise to truly use a full 256MB of ram to it's full potential. Concerning heat + power draw, the PCI-E version should run cooler, but don't expect a massive difference.
That said, if you were to move into the 6800 range, a 128 card might actually in turn
limit the card a bit. Of course, this is assuming you unlock the pipelines. If you have no idea what that means, you can consult some of the other members here as to what all that means, and how to actually unlock these "pipelines". It generally greatly boosts preformance, and is the only way you can really get a 6800NU or 6800XT to outpreform a 6600GT. (At stock speeds, the 6600GT outpreforms both the 6800NU & 6800XT; only when unlocked will the 6800NU & XT beat the 6600GT)
So, in summary:
1. Avoid the PCX5900.
2. 6600GT if you don't plan to overclock.
3. 6800XT if you
do plan to overclock.