Only old 16 bit games won't run on Vista x64,most of the 32 bit games should run ok,worst case you'll have to put the game in WinXP SP2 compatibility mode and select "run as admin" in properties of the game concerned.
It works, but make sure you run it in admin mode and not from the "Games" menu. When I tried it the WoW patcher couldn't update my game because it coudln't edit some files or something. That's the only hang up I had with it.
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