NTVDM was originally meant to allow for running DOS programs in 64 bit modes. In 2020, they added the ability to run 16-bit Windows apps, which is what MESA2002 needs. Here is the section of notes from the github site. Perhaps you may want to run WINEVDM instead.
I want to run 16bit Windows applications
---------------------------------------------------------------------------
As of 05/2020, NTVDMx64 now generally supports WOW32, so your applications
should run.
However, they currently only work with the CCPU build and we know that the
CCPU is slow, so I still recommend wineVDM:
https://github.com/otya128/winevdm
The loader tries to detect if winevdm is installed and if so, it gets
precedence over NTVDMx64. If you restore original registry entries, WOW32
will be handled by NTVDMx64 again.
The crucial registry key for the check is:
HKEY_LOCAL_MACHINE\SOFTWARE\Microsoft\Windows NT\CurrentVersion\NtVdm64\0OTVDM
If it is present, NTVDMx64 won't load its WOW32 implementation.
Please note, that detection of the key is done upon inital load of ldntvdm.dll
into the process address space, so if you toggle the 0OTVDM, the process where
you are launching your 16 bit application from needs to be restarted.
If unsure, you can reboot your machine after installation/uninstallation of
WineVDM handlers.
To debug wow32, before launching your application:
set WOWTRACE=C:\log.txt
set WOWLOGLVL=16
For more detailled information about debugging, please refer to
doc\debug-wow.txt