Normally you don't need VDTV or video patch, so leave them at off.
I run my out of region backups with
video: game default
funny they don't run with forcing PAL or using console default don't ask me why.
+ some games need special attention as you may know, so depending on your current cIOS setup you either have to choose another one in the loader settings (i run all using 250, 223 für music games for example) or even have ti install one (check with syscheck or run the softmod any wii guide) Maybe that helps.