Bring a large pot of salted water to boil.

In a large skillet, heat olive oil to medium high; add sausage.

Saute meat stirring as needed until cooked through (about 5 minutes).

Pork fat blends with olive oil; do not attempt to remove any of this combined fat.

Add minced garlic, Italian seasoning, and red pepper flakes; cook about one more minute.

Add canned tomatoes with juice and bring to a boil.

Lower heat to simmer and cook for 20 minutes uncovered.

During the last 10 minutes of the sauce simmering, add pasta to boiling water and cook until al dente.

After the 20 minute simmer, add the heavy cream to the sauce and continue to cook until slightly thickened.

Adjust sauce flavor with salt and pepper to taste.

Drain pasta, reserving 1/2 cup of pasta water.

In a large mixing bowl, combine cooked pasta, tomato sauce, 1/2 cup pasta water, and parmesan cheese.

Toss well and serve with extra parmesan to taste.