Bring a large pot of salted water to a boil, and start to cook 1 pound rigatoni according to the package directions. While the pasta cooks, start to prepare the sauce.

Remove casings from 12 ounces spicy Italian sausage. Add the sausage to a large skillet and cook on medium-high heat, breaking it up into small pieces with a wooden spoon, until browned, about 5 minutes.

With a slotted spoon, transfer the sausage to a bowl.

Discard all but 1 tablespoon fat from the skillet.

Return the sausage to the skillet.

Using the garlic press, crush the 3 garlic cloves into the skillet. Cook, stirring, for 30 seconds.

Stir in 2 tablespoons tomato paste and cook 2 minutes.

Stir in 1 (28-ounce) can crushed tomatoes, 1 tablespoon red wine vinegar, and 1/2 teaspoon salt. Bring to a simmer, and cook until the sauce slightly thickens, about 7 minutes.

Stir in 1/2 cup finely grated Parmesan cheese and 1/4 cup heavy cream.

Serve the sauce over the pasta and top with more Parmesan cheese if desired.