Once the host is upgraded to ESXi 5 we need to install the new driver:
1) scp MYC-myri10ge-1.5.3-offline_bundle-467813.zip net-myri10ge-1.5.3-1OEM.500.0.0.406165.x86_64.vib root@esxi5-02:/var/log/vmware
2) ssh esxi5-02 as root
3) /var/log/vmware # esxcli software vib install -d MYC-myri10ge-1.5.3-offline_bundle-467813.zip
Message: The update completed successfully, but the system needs to be rebooted for the changes to be effective.
Reboot Required: true
VIBs Installed: Myricom_bootbank_net-myri10ge_1.5.3-1OEM.500.0.0.406165
4) reboot and verify the card is discovered (vCenter Config->Network->Network Adapters->Add)
There is also a new method to import these as "patch extensions" into vCenter, then attach them like baselines to hosts. My first pass at this went well, except the remediation step reported the patch was not applicable and it was skipped!