I'll just wait for patches/fixes and a few visual mods.

You mean more fallout 3? Not really ''more fallout'' if you mean't the originals....

My reason: More Fallout.  And bugs can be fixed through patches, even that some are major and game breaking. Like corrupted saves, crash and memory leaks.

But is it enough to take away from the general "Falloutness" of the game? Fallout 3 was plagued with technical issues and bugs and that didn't stop me from having a positive experience with the game. 
 
Some of the issues in Fallout 3 had me thinking to myself that, in a game like Halo or Gears, they would have been the end of the series. In Fallout 3, however, I didn't really take issue with them and was willing to deal with that.  Not really sure why, though.

Keep playing. The game has massive issues with bugs and tech issues. 

So, I'm not going to pretend like I've beaten Fallout:NV, I'm actually only about an hour into the game, but I recently got into it with a friend on twitter about whether or not he was going to get this game.  His argument was that the game was made by Obsidian Entertainment, and because of the near-complete failures of Alpha Protocol and KOTOR II, he was going to wait and see how this game shaped up before he bought it.  My argument was that this game was being built on the framework that already existed from Fallout 3 and that, despite what would inevitably be a buggy game (proven by gameplay and the recent review on GB), it was still going to be a Fallout game and would, therefore, be something worth devoting time.
 
One hour into Fallout:NV and I couldn't be any more right.
 
Is the game a bit buggy? Sure
Are the graphics not the best on the market today? Probably (but who really cares)
Is it still Fallout 3-style gameplay? Absolutely.
 
And that, more than anything, is the reason to pick up this game.  I put almost 100 hours into Fallout 3, and judging from what I've read, that's less than average for the people that enjoyed Fallout 3.  I can't see how, despite bugs and glitches, you wouldn't enjoy this game if you were one of those people.
 
I win.