Heat olive oil in a large deep skillet over medium-high heat. Add the sausage, breaking it into small crumbles with a wooden spoon, and cook for 5 to 6 minutes until browned and cooked through.

Reduce heat to medium. Add the garlic and red pepper flakes and cook for 1 minute. Pour in the crushed tomatoes, stir to combine, and simmer for 5 minutes.

Stir in the heavy cream and Parmesan cheese until the sauce is smooth and creamy. Season with salt and pepper. Keep warm on low heat.

Meanwhile, cook the rigatoni in a large pot of salted boiling water until al dente. Reserve 1/2 cup pasta water and drain. Add the pasta to the sauce and toss to coat, adding pasta water as needed. Serve topped with extra Parmesan and fresh basil.