Right at the start of her business my mum in law printed her own cards using her computer, a printer and a pack of pre perforated cards held together in an A4 sheet (hope that makes sense).
But I imagine that professional companies print a specific sized sheet with the repeat design (lets say A4 for the sake of argument) then a machine chops the individual cards with a grid cutter (again hope this makes sense ... tired and shouldn't really be twittering on but I've started now ).
Ask Pete at PVCprinting, he does it digitally and can even do you a one off if you want.
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JohnG
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We use a £500,000 Ryobi Printing Press fed with plates from £80,000 worth of Screen Computer to Plate (CTP) equipment and the Business Cards are trimmed on £30,000 worth of Schneider Guillotine.
That said, a £100,000 digital press could do the job as well