uhm just a question ..but what version of win 7 are you using sickness? you said x64 bit.... but what version of win 7 ? home premium? professional? ultimate?
Ive got the win 7 ultimate x64 bit and i run 32 bit games on it with no problem. mind you i also have the win xp compat setting that comes with professional or better for win 7 ..(i'll have to talk to the guys at microsoft for the xp compat for all their win 7 and not JUST the last 4.)
as for the patches. just make sure that you right click and hit properties and then choose the compat setting appropriate to your needs ..:P
even patches can be installed and run np.
ive got diablo 2 with the expansion installed and it plays without problems

patches and all.. Happily i might add.
so perhaps its actually a setting issue .. but i don't think.. unless you don't have professional at least..that you would have an issue with the patch..:P
the only way you can know is to try.
and its certainly better than having to fully reformat a harddrive and losing valuable data.
Best of Luck