In a large skillet, heat the oil over a medium high abd add sausage meat. Break up with wooden spoon and brown. Add the minced garlic and sauté for 2 minutes.
Reduce the heat to medium and add the wine (optional), tomato paste, sugar, dried oregano and salt and red pepper flakes, sauté for 2 minutes.
Add the tomatoes, stir and simmer until reduced slightly, about 20 minutes (Start to make the polenta). In last 10 minutes of simmering, add the basil and stir. Season the sauce with more salt to taste.
Polenta
Bring water, olive oil and salt to a boil.
Slowly whisk in the dry polenta and to avoid lumps. Cook on low for 10 minutes. This will sputter so keep on low and watch out.
Add the heavy cream, black pepper, grated Romano cheese. Stir to incorporate. Simmer for another 15 minutes more. If it gets too thick you can thin it out with more chicken stock or water, to your liking.
Season to taste and take off the heat. Divide polenta in serving bowls and top with sausage gravy. Serve with freshly grated parmesan cheese and parsley.
Video
Notes
Optionally: Purchase 2 pounds hot Italian sausage and use 1 pound for ragu sauce and grill or pan fry the other pound of sausages to top each bowl as shown.
As this recipe is written, the flavors are amazing, although if cooking this low and slow (3-4 hour simmer stovetop), I would omit the tomato paste as this will thicken on it's own. I use the tomato paste when time is tight.
Per The Kitchn, San Marzano tomatoes are grown in the rich volcanic soil at the base of Mount Vesuvius, which gives them a sweet flavor and low acidity and they are coveted for their firm pulp, deep red color, easy to remove skin and low seed count. Feel free to use whatever brand you prefer.