Bring a large pot of salted water to a rolling boil. Add the pasta and cook according to package instructions until al dente, about 8-10 minutes. Reserve about a cup of pasta water before draining.

In a food processor, combine basil, pine nuts, garlic, and Parmesan. Pulse until finely chopped. With the processor running, drizzle in olive oil until the pesto is smooth.

In a skillet over medium heat, add the prepared pesto and heavy cream, stirring gently for about 2-3 minutes until slightly bubbling. Adjust consistency with reserved pasta water if needed.

Transfer the drained pasta to the skillet with the sauce and toss gently to coat. Add reserved pasta water as necessary to reach the desired creaminess.

Serve in bowls, garnished with extra Parmesan and fresh basil leaves.