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In a large pot of boiling salted water, cook pasta according to package instructions; drain well.
Melt butter in a large stockpot or Dutch oven over medium heat. Add garlic and onion to the skillet, and cook, stirring often, until onions have become translucent, about 3-4 minutes.
Stir in crushed tomatoes, basil, oregano, parsley and red pepper flakes; season with salt and pepper, to taste.
Bring to a boil; reduce heat to low and simmer, stirring occasionally, until sauce has thickened, about 15-20 minutes. Stir in balsamic vinegar.
Stir in milk and heavy cream until well combined and heated through, about 2 minutes.
Serve immediately, garnished with Parmesan and parsley, if desired.